Comparing the predictive accuracy of frailty, comorbidity, and disability for mortality: a 1-year follow-up in patients hospitalized in geriatric wards
Martin Ritt,1,2 Julia Isabel Ritt,2 Cornel Christian Sieber,1,3 Karl-Günter Gaßmann1,2 1Institute for Biomedicine of Ageing (IBA), Friedrich-Alexander Universität Erlangen-Nürnberg (FAU), Nürnberg, 2Department of Internal Medicine III (Medicine of Agein...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2017-02-01
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| Series: | Clinical Interventions in Aging |
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| Online Access: | https://www.dovepress.com/comparing-the-predictive-accuracy-of-frailty-comorbidity-and-disabilit-peer-reviewed-article-CIA |
| _version_ | 1818571148878675968 |
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| author | Ritt M Ritt JI Sieber CC Gaßmann KG |
| author_facet | Ritt M Ritt JI Sieber CC Gaßmann KG |
| author_sort | Ritt M |
| collection | DOAJ |
| description | Martin Ritt,1,2 Julia Isabel Ritt,2 Cornel Christian Sieber,1,3 Karl-Günter Gaßmann1,2 1Institute for Biomedicine of Ageing (IBA), Friedrich-Alexander Universität Erlangen-Nürnberg (FAU), Nürnberg, 2Department of Internal Medicine III (Medicine of Ageing), Geriatrics Centre Erlangen, Hospital of the Congregation of St Francis Sisters of Vierzehnheiligen, Erlangen, 3Department of Internal Medicine and Geriatrics, Hospital of the Order of St John of God, Regensburg, Germany Background: Studies evaluating and comparing the power of frailty, comorbidity, and disability instruments, together and in parallel, for predicting mortality are limited.Objective: This study aimed to evaluate and compare the measures of frailty, comorbidity, and disability in predicting 1-year mortality in geriatric inpatients.Design: Prospective cohort study.Patients and setting: A total of 307 inpatients aged ≥65 years in geriatric wards of a general hospital participated in the study.Measurements: The patients were evaluated in relation to different frailty, comorbidity, and disability instruments during their hospital stays. These included three frailty (the seven-category Clinical Frailty Scale [CFS-7], a 41-item frailty index [FI], and the FRAIL scale), two comorbidity (the Cumulative Illness Rating Scale for Geriatrics [CIRS-G] and the comorbidity domain of the FI [Comorbidity-D-FI]), and two disability instruments (disability in basic activities of daily living [ADL-Katz] and the instrumental and basic activities of daily living domains of the FI [IADL/ADL-D-FI]). The patients were followed-up over 1 year.Results: Using FI, CIRS-G, Comorbidity-D-FI, and ADL-Katz, this study identified a patient group with a high (≥50%) 1-year mortality rate in all of the patients and the two patient subgroups (ie, patients aged 65–82 years and ≥83 years). The CFS-7, FI, FRAIL scale, CIRS-G, Comorbidity-D-FI, and IADL/ADL-D-FI (analyzed as full scales) revealed useful discriminative accuracy for 1-year mortality (ie, an area under the curve >0.7) in all the patients and the two patient subgroups (all P<0.001). Thereby, CFS-7 (in all patients and the two patient subgroups) and FI (in the subgroup of patients aged ≥83 years) showed greater discriminative accuracy for 1-year mortality compared to other instruments (all P<0.05).Conclusion: All the different instruments emerged as suitable tools for risk stratification in geriatric inpatients. Among them, CFS-7, and in those patients aged ≥83 years, also the FI, might most accurately predict 1-year mortality in the aforementioned group of individuals. Keywords: frailty, comorbidity, disability, hospitalized geriatric patients, older people, health status, survival |
| first_indexed | 2024-12-14T13:51:53Z |
| format | Article |
| id | doaj.art-11b5041005e44559a9c0ea617ed6e9ba |
| institution | Directory Open Access Journal |
| issn | 1178-1998 |
| language | English |
| last_indexed | 2024-12-14T13:51:53Z |
| publishDate | 2017-02-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Clinical Interventions in Aging |
| spelling | doaj.art-11b5041005e44559a9c0ea617ed6e9ba2022-12-21T22:59:02ZengDove Medical PressClinical Interventions in Aging1178-19982017-02-01Volume 1229330431213Comparing the predictive accuracy of frailty, comorbidity, and disability for mortality: a 1-year follow-up in patients hospitalized in geriatric wardsRitt MRitt JISieber CCGaßmann KGMartin Ritt,1,2 Julia Isabel Ritt,2 Cornel Christian Sieber,1,3 Karl-Günter Gaßmann1,2 1Institute for Biomedicine of Ageing (IBA), Friedrich-Alexander Universität Erlangen-Nürnberg (FAU), Nürnberg, 2Department of Internal Medicine III (Medicine of Ageing), Geriatrics Centre Erlangen, Hospital of the Congregation of St Francis Sisters of Vierzehnheiligen, Erlangen, 3Department of Internal Medicine and Geriatrics, Hospital of the Order of St John of God, Regensburg, Germany Background: Studies evaluating and comparing the power of frailty, comorbidity, and disability instruments, together and in parallel, for predicting mortality are limited.Objective: This study aimed to evaluate and compare the measures of frailty, comorbidity, and disability in predicting 1-year mortality in geriatric inpatients.Design: Prospective cohort study.Patients and setting: A total of 307 inpatients aged ≥65 years in geriatric wards of a general hospital participated in the study.Measurements: The patients were evaluated in relation to different frailty, comorbidity, and disability instruments during their hospital stays. These included three frailty (the seven-category Clinical Frailty Scale [CFS-7], a 41-item frailty index [FI], and the FRAIL scale), two comorbidity (the Cumulative Illness Rating Scale for Geriatrics [CIRS-G] and the comorbidity domain of the FI [Comorbidity-D-FI]), and two disability instruments (disability in basic activities of daily living [ADL-Katz] and the instrumental and basic activities of daily living domains of the FI [IADL/ADL-D-FI]). The patients were followed-up over 1 year.Results: Using FI, CIRS-G, Comorbidity-D-FI, and ADL-Katz, this study identified a patient group with a high (≥50%) 1-year mortality rate in all of the patients and the two patient subgroups (ie, patients aged 65–82 years and ≥83 years). The CFS-7, FI, FRAIL scale, CIRS-G, Comorbidity-D-FI, and IADL/ADL-D-FI (analyzed as full scales) revealed useful discriminative accuracy for 1-year mortality (ie, an area under the curve >0.7) in all the patients and the two patient subgroups (all P<0.001). Thereby, CFS-7 (in all patients and the two patient subgroups) and FI (in the subgroup of patients aged ≥83 years) showed greater discriminative accuracy for 1-year mortality compared to other instruments (all P<0.05).Conclusion: All the different instruments emerged as suitable tools for risk stratification in geriatric inpatients. Among them, CFS-7, and in those patients aged ≥83 years, also the FI, might most accurately predict 1-year mortality in the aforementioned group of individuals. Keywords: frailty, comorbidity, disability, hospitalized geriatric patients, older people, health status, survival https://www.dovepress.com/comparing-the-predictive-accuracy-of-frailty-comorbidity-and-disabilit-peer-reviewed-article-CIAFrailtyco-morbiditydisabilityhospitalized geriatric patients |
| spellingShingle | Ritt M Ritt JI Sieber CC Gaßmann KG Comparing the predictive accuracy of frailty, comorbidity, and disability for mortality: a 1-year follow-up in patients hospitalized in geriatric wards Clinical Interventions in Aging Frailty co-morbidity disability hospitalized geriatric patients |
| title | Comparing the predictive accuracy of frailty, comorbidity, and disability for mortality: a 1-year follow-up in patients hospitalized in geriatric wards |
| title_full | Comparing the predictive accuracy of frailty, comorbidity, and disability for mortality: a 1-year follow-up in patients hospitalized in geriatric wards |
| title_fullStr | Comparing the predictive accuracy of frailty, comorbidity, and disability for mortality: a 1-year follow-up in patients hospitalized in geriatric wards |
| title_full_unstemmed | Comparing the predictive accuracy of frailty, comorbidity, and disability for mortality: a 1-year follow-up in patients hospitalized in geriatric wards |
| title_short | Comparing the predictive accuracy of frailty, comorbidity, and disability for mortality: a 1-year follow-up in patients hospitalized in geriatric wards |
| title_sort | comparing the predictive accuracy of frailty comorbidity and disability for mortality a 1 year follow up in patients hospitalized in geriatric wards |
| topic | Frailty co-morbidity disability hospitalized geriatric patients |
| url | https://www.dovepress.com/comparing-the-predictive-accuracy-of-frailty-comorbidity-and-disabilit-peer-reviewed-article-CIA |
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