Analysis of the Impact of the Fragility of the Over 70 Years of TIAprognosis (AIT70)

Fondation Hôpital Saint-Joseph

Status: Active, not recruiting

Conditions: Stoke; Transient Ischemic Attack; Vascular; Ischemic

Treatments: Other: No intervention

Study type: Observational

Funder types: Other

Identifiers

NCT02828488

AIT70

Details and patient eligibility

About

Fragility, geriatric concept recent identification is defined by simple physical indicators. The literature suggests that it is related to the risk of hospitalization, falls, institutionalization and death. Some studies have shown a link with heart disease, including heart failure. The link with the TIA (transient ischemic attack) has however never been studied. A fortiori, the impact of the fragility of the risk of recurrent stroke after TIA is unknown.

Several questions need to be asked: Among older patients hospitalized for TIA, what proportion of those completing the criteria of frailty? In this same population, is there a correlation between fragility and scores ABCD2 score itself predictive of the risk of subsequent ischemic stroke? In other words, fragile subjects who have a TIA Have a higher risk of ischemic stroke (which could cause a strengthening of prevention measures)?

Full description

Hypotheses :

• Frailty is common among the elderly patient population who have a TIA. Compared to control groups of literature.
• Patients with high fragility score ABCD2 also have a high score.
• Patients with a high score of fragility also have a significant number of vascular risk factors (including atrial fibrillation)
• Patients with a high score of fragility also have an average length of stay (ALOS) higher than the others. So underlying the question is: can we learn to better identify patients who are going to need a bigger structure their output at home.

objectives:

• Assess the feasibility of placing a fragile test in acute phase of AIT in USINV.

• To evaluate the frequency of frailty among the population of elderly patients who have a TIA.

• Compare in AIT over 70 years those with fragile high score to those with low scores, especially for ABCD2 score, vascular risk factors and the DMS.

• Statements parameters:

  o The fragility score:

• Choice of fragility score: among the fragility of scores, the most used in international literature is the score of Linda Fried. Moreover, the stress of the study is related to the environment of the USINV (shortly, short DMS, often tired patients). It is therefore important to use this study for a test only, but quick handover. The score Fried also has the advantage (J Gerontol A Biol Sci Med Sci 2001, 56 (3): M146-56) The first 4 items are simple clinical evaluation. The 5th (grip test) will be performed with a device (single gauge measuring the fingers bending strength) loan from the geriatric ward.

Enrollment: 110 patients

Sex: All

Ages: 70+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• The TIA is defined pragmatically: any sudden deficit with blood systematization ≤ 1 hour. Among these "TIA", we know that a subgroup may possibly have an MRI with diffusion lesion, indicating a recent ischemic stroke. This subgroup of transient accident is recognized as being at higher risk of recurrence. This criterion will be taken into account in the data analysis.

Exclusion criteria

• history of stroke with Rankin score of ≥ 2.
• Dementia
• Severe depression
• evolutionary Cancer
• Heart Failure