Operationalizing a frailty index using routine blood and urine tests
Martin Ritt,1,2 Jakob Jäger,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), Nuremberg, Germany; 2Department of Internal Medicin...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2017-06-01
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| Series: | Clinical Interventions in Aging |
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| Online Access: | https://www.dovepress.com/operationalizing-a-frailty-index-using-routine-blood-and-urine-tests-peer-reviewed-article-CIA |
| _version_ | 1818852378107969536 |
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| author | Ritt M Jäger J Ritt JI Sieber CC Gaßmann KG |
| author_facet | Ritt M Jäger J Ritt JI Sieber CC Gaßmann KG |
| author_sort | Ritt M |
| collection | DOAJ |
| description | Martin Ritt,1,2 Jakob Jäger,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), Nuremberg, Germany; 2Department of Internal Medicine III (Medicine of Ageing), Geriatrics Center Erlangen, Hospital of the Congregation of St Francis Sisters of Vierzehnheiligen, Erlangen, Germany; 3Department of General Internal Medicine and Geriatrics, Hospital of the Order of St John of God, Regensburg, Germany Background: Uncomplicated frailty instruments are desirable for use in a busy clinical setting. The aim of this study was to operationalize a frailty index (FI) from routine blood and urine tests, and to evaluate the properties of this FI compared to other frailty instruments.Materials and methods: We conducted a secondary analysis of a prospective cohort study on 306 patients aged ≥65 years hospitalized on geriatric wards. An FI comprising 22 routine blood parameters and one standard urine parameter (FI-Lab), a 50-item FI based on a comprehensive geriatric assessment (FI-CGA), a combined FI (FI-combined [items from the FI-Lab + others from the FI-CGA]), the Clinical Frailty Scale, rule-based frailty definition, and frailty phenotype were operationalized from data obtained during patients’ hospital stays (ie, before discharge [baseline examination]). Follow-up data were obtained up to 1 year after the baseline examination.Results: The mean FI-Lab score was 0.34±15, with an upper limit of 0.74. The FI-Lab was correlated with all the other frailty instruments (all P<0.001). The FI-Lab revealed an area under the receiver-operating characteristic curve (AUC) for 6-month and 1-year mortality of 0.765 (0.694–0.836) and 0.769 (0.706–0.833), respectively (all P<0.001). Each 0.01 increment in FI-Lab increased the risk (adjusted for age and sex) for 6-month and 1-year mortality by 7.2% and 7.1%, respectively (all adjusted P<0.001). When any of the other FIs (except the FI-combined) were also included in the models, each 0.01 increment in FI-Lab score was associated with an increase in the risk of 6-month and 1-year mortality by 4.1%–5.4% (all adjusted P<0.001).Conclusion: The FI-Lab showed key characteristics of an FI. The FI-Lab can be applied as a single frailty measure or in combination with/in addition to other frailty instruments. Keywords: older people, hospital, geriatric wards, frailty, risk stratification, mortality |
| first_indexed | 2024-12-19T07:19:58Z |
| format | Article |
| id | doaj.art-fa6d538408234de9877535f4bdf46ef4 |
| institution | Directory Open Access Journal |
| issn | 1178-1998 |
| language | English |
| last_indexed | 2024-12-19T07:19:58Z |
| publishDate | 2017-06-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Clinical Interventions in Aging |
| spelling | doaj.art-fa6d538408234de9877535f4bdf46ef42022-12-21T20:30:58ZengDove Medical PressClinical Interventions in Aging1178-19982017-06-01Volume 121029104033478Operationalizing a frailty index using routine blood and urine testsRitt MJäger JRitt JISieber CCGaßmann KGMartin Ritt,1,2 Jakob Jäger,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), Nuremberg, Germany; 2Department of Internal Medicine III (Medicine of Ageing), Geriatrics Center Erlangen, Hospital of the Congregation of St Francis Sisters of Vierzehnheiligen, Erlangen, Germany; 3Department of General Internal Medicine and Geriatrics, Hospital of the Order of St John of God, Regensburg, Germany Background: Uncomplicated frailty instruments are desirable for use in a busy clinical setting. The aim of this study was to operationalize a frailty index (FI) from routine blood and urine tests, and to evaluate the properties of this FI compared to other frailty instruments.Materials and methods: We conducted a secondary analysis of a prospective cohort study on 306 patients aged ≥65 years hospitalized on geriatric wards. An FI comprising 22 routine blood parameters and one standard urine parameter (FI-Lab), a 50-item FI based on a comprehensive geriatric assessment (FI-CGA), a combined FI (FI-combined [items from the FI-Lab + others from the FI-CGA]), the Clinical Frailty Scale, rule-based frailty definition, and frailty phenotype were operationalized from data obtained during patients’ hospital stays (ie, before discharge [baseline examination]). Follow-up data were obtained up to 1 year after the baseline examination.Results: The mean FI-Lab score was 0.34±15, with an upper limit of 0.74. The FI-Lab was correlated with all the other frailty instruments (all P<0.001). The FI-Lab revealed an area under the receiver-operating characteristic curve (AUC) for 6-month and 1-year mortality of 0.765 (0.694–0.836) and 0.769 (0.706–0.833), respectively (all P<0.001). Each 0.01 increment in FI-Lab increased the risk (adjusted for age and sex) for 6-month and 1-year mortality by 7.2% and 7.1%, respectively (all adjusted P<0.001). When any of the other FIs (except the FI-combined) were also included in the models, each 0.01 increment in FI-Lab score was associated with an increase in the risk of 6-month and 1-year mortality by 4.1%–5.4% (all adjusted P<0.001).Conclusion: The FI-Lab showed key characteristics of an FI. The FI-Lab can be applied as a single frailty measure or in combination with/in addition to other frailty instruments. Keywords: older people, hospital, geriatric wards, frailty, risk stratification, mortalityhttps://www.dovepress.com/operationalizing-a-frailty-index-using-routine-blood-and-urine-tests-peer-reviewed-article-CIAOlder peoplehospitalgeriatric wardsfrailtyrisk stratificationmortality |
| spellingShingle | Ritt M Jäger J Ritt JI Sieber CC Gaßmann KG Operationalizing a frailty index using routine blood and urine tests Clinical Interventions in Aging Older people hospital geriatric wards frailty risk stratification mortality |
| title | Operationalizing a frailty index using routine blood and urine tests |
| title_full | Operationalizing a frailty index using routine blood and urine tests |
| title_fullStr | Operationalizing a frailty index using routine blood and urine tests |
| title_full_unstemmed | Operationalizing a frailty index using routine blood and urine tests |
| title_short | Operationalizing a frailty index using routine blood and urine tests |
| title_sort | operationalizing a frailty index using routine blood and urine tests |
| topic | Older people hospital geriatric wards frailty risk stratification mortality |
| url | https://www.dovepress.com/operationalizing-a-frailty-index-using-routine-blood-and-urine-tests-peer-reviewed-article-CIA |
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