Development and validation of retrospective electronic frailty index using operational data of aged care homes
Abstract Background Although elderly population is generally frail, it is important to closely monitor their health deterioration to improve the care and support in residential aged care homes (RACs). Currently, the best identification approach is through time-consuming regular geriatric assessments...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-12-01
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| Series: | BMC Geriatrics |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12877-022-03616-0 |
| _version_ | 1828288842881302528 |
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| author | Tabinda Sarwar Antonio Jose Jimeno Yepes Xiuzhen Zhang Jeffrey Chan Irene Hudson Sarah Evans Lawrence Cavedon |
| author_facet | Tabinda Sarwar Antonio Jose Jimeno Yepes Xiuzhen Zhang Jeffrey Chan Irene Hudson Sarah Evans Lawrence Cavedon |
| author_sort | Tabinda Sarwar |
| collection | DOAJ |
| description | Abstract Background Although elderly population is generally frail, it is important to closely monitor their health deterioration to improve the care and support in residential aged care homes (RACs). Currently, the best identification approach is through time-consuming regular geriatric assessments. This study aimed to develop and validate a retrospective electronic frailty index (reFI) to track the health status of people staying at RACs using the daily routine operational data records. Methods We have access to patient records from the Royal Freemasons Benevolent Institution RACs (Australia) over the age of 65, spanning 2010 to 2021. The reFI was developed using the cumulative deficit frailty model whose value was calculated as the ratio of number of present frailty deficits to the total possible frailty indicators (32). Frailty categories were defined using population quartiles. 1, 3 and 5-year mortality were used for validation. Survival analysis was performed using Kaplan-Meier estimate. Hazard ratios (HRs) were estimated using Cox regression analyses and the association was assessed using receiver operating characteristic (ROC) curves. Results Two thousand five hundred eighty-eight residents were assessed, with an average length of stay of 1.2 ± 2.2 years. The RAC cohort was generally frail with an average reFI of 0.21 ± 0.11. According to the Kaplan-Meier estimate, survival varied significantly across different frailty categories (p < 0.01). The estimated hazard ratios (HRs) were 1.12 (95% CI 1.09–1.15), 1.11 (95% CI 1.07–1.14), and 1.1 (95% CI 1.04–1.17) at 1, 3 and 5 years. The ROC analysis of the reFI for mortality outcome showed an area under the curve (AUC) of ≥0.60 for 1, 3 and 5-year mortality. Conclusion A novel reFI was developed using the routine data recorded at RACs. reFI can identify changes in the frailty index over time for elderly people, that could potentially help in creating personalised care plans for addressing their health deterioration. |
| first_indexed | 2024-04-13T10:11:16Z |
| format | Article |
| id | doaj.art-deb5fd078cf64a07a1d3e44f96f9fce8 |
| institution | Directory Open Access Journal |
| issn | 1471-2318 |
| language | English |
| last_indexed | 2024-04-13T10:11:16Z |
| publishDate | 2022-12-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Geriatrics |
| spelling | doaj.art-deb5fd078cf64a07a1d3e44f96f9fce82022-12-22T02:50:55ZengBMCBMC Geriatrics1471-23182022-12-0122111110.1186/s12877-022-03616-0Development and validation of retrospective electronic frailty index using operational data of aged care homesTabinda Sarwar0Antonio Jose Jimeno Yepes1Xiuzhen Zhang2Jeffrey Chan3Irene Hudson4Sarah Evans5Lawrence Cavedon6School of Computing Technologies, RMIT UniversitySchool of Computing Technologies, RMIT UniversitySchool of Computing Technologies, RMIT UniversitySchool of Computing Technologies, RMIT UniversityMathematical Sciences, School of Science, RMIT UniversityTelstra HealthSchool of Computing Technologies, RMIT UniversityAbstract Background Although elderly population is generally frail, it is important to closely monitor their health deterioration to improve the care and support in residential aged care homes (RACs). Currently, the best identification approach is through time-consuming regular geriatric assessments. This study aimed to develop and validate a retrospective electronic frailty index (reFI) to track the health status of people staying at RACs using the daily routine operational data records. Methods We have access to patient records from the Royal Freemasons Benevolent Institution RACs (Australia) over the age of 65, spanning 2010 to 2021. The reFI was developed using the cumulative deficit frailty model whose value was calculated as the ratio of number of present frailty deficits to the total possible frailty indicators (32). Frailty categories were defined using population quartiles. 1, 3 and 5-year mortality were used for validation. Survival analysis was performed using Kaplan-Meier estimate. Hazard ratios (HRs) were estimated using Cox regression analyses and the association was assessed using receiver operating characteristic (ROC) curves. Results Two thousand five hundred eighty-eight residents were assessed, with an average length of stay of 1.2 ± 2.2 years. The RAC cohort was generally frail with an average reFI of 0.21 ± 0.11. According to the Kaplan-Meier estimate, survival varied significantly across different frailty categories (p < 0.01). The estimated hazard ratios (HRs) were 1.12 (95% CI 1.09–1.15), 1.11 (95% CI 1.07–1.14), and 1.1 (95% CI 1.04–1.17) at 1, 3 and 5 years. The ROC analysis of the reFI for mortality outcome showed an area under the curve (AUC) of ≥0.60 for 1, 3 and 5-year mortality. Conclusion A novel reFI was developed using the routine data recorded at RACs. reFI can identify changes in the frailty index over time for elderly people, that could potentially help in creating personalised care plans for addressing their health deterioration.https://doi.org/10.1186/s12877-022-03616-0Frail elderlyFrailty indexMortalityHealth deteriorationAged care homesElectronic health records |
| spellingShingle | Tabinda Sarwar Antonio Jose Jimeno Yepes Xiuzhen Zhang Jeffrey Chan Irene Hudson Sarah Evans Lawrence Cavedon Development and validation of retrospective electronic frailty index using operational data of aged care homes BMC Geriatrics Frail elderly Frailty index Mortality Health deterioration Aged care homes Electronic health records |
| title | Development and validation of retrospective electronic frailty index using operational data of aged care homes |
| title_full | Development and validation of retrospective electronic frailty index using operational data of aged care homes |
| title_fullStr | Development and validation of retrospective electronic frailty index using operational data of aged care homes |
| title_full_unstemmed | Development and validation of retrospective electronic frailty index using operational data of aged care homes |
| title_short | Development and validation of retrospective electronic frailty index using operational data of aged care homes |
| title_sort | development and validation of retrospective electronic frailty index using operational data of aged care homes |
| topic | Frail elderly Frailty index Mortality Health deterioration Aged care homes Electronic health records |
| url | https://doi.org/10.1186/s12877-022-03616-0 |
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