Abstract：
With a constant increase in prevalence and incidence worldwide, stroke remains a public health issue in the 21st century. Additionally, population aging inevitably leads to increased vulnerability in the general population, a clinical state known as frailty. While there are adequate guidelines on the treatment of stroke in the acute setting, there are a lot of gaps regarding the chronic management of stroke patients, particularly the frail ones. From the therapeutic point of view, palliative care could be the key to offering complex and individualized treatment to these frail chronic stroke patients. In the context of the heterogeneous data and incomplete therapeutic guidelines, this article provides a new and original perspective on the topic, aiming to increase awareness and understanding and improve palliative care management in stroke patients. Based on current knowledge, the authors describe a new concept called the frailty-stroke continuum and offer a detailed explanation of the intricate stroke-frailty connection in the first part. After understanding the role of palliative care in managing this kind of patients, the authors discuss the most relevant practical aspects aiming to offer an individualized framework for daily clinical practice. The novel approach consists of developing a four-step scale for characterizing frail stroke patients, with the final aim of providing personalized treatment and correctly evaluating prognosis. By pointing out the limitations of current guidelines and the challenges of new research directions, this article opens the pathway for the better evaluation of frail stroke patients, offering a better perception of patients\' prognosis.
摘要：
随着全球患病率和发病率的不断增加，中风仍然是21世纪的公共卫生问题。此外,人口老龄化不可避免地导致普通人群的脆弱性增加，一种被称为虚弱的临床状态。虽然有关于急性中风治疗的适当指南，在中风病人的慢性管理方面有很多差距，尤其是体弱者。从治疗的角度来看，姑息治疗可能是为这些虚弱的慢性卒中患者提供复杂和个性化治疗的关键.在异构数据和不完整的治疗指南的背景下，这篇文章提供了一个新的和独创的观点，旨在提高对中风患者的认识和理解，并改善姑息治疗管理。根据现有知识,作者在第一部分描述了一个称为虚弱-中风连续体的新概念，并对复杂的中风-虚弱联系进行了详细解释。在了解了姑息治疗在管理这类患者中的作用之后，作者讨论了最相关的实践方面，旨在为日常临床实践提供个性化框架。新的方法包括开发一个四步量表来表征虚弱的中风患者，最终目的是提供个性化治疗和正确评估预后。通过指出当前指南的局限性和新研究方向的挑战，本文为更好地评估虚弱的中风患者开辟了道路，提供更好的患者预后感知。
