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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Autores principales:	Ritt M, Jäger J, Ritt JI, Sieber CC, Gaßmann KG
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2017
Materias:	Older people hospital geriatric wards frailty risk stratification mortality Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/fa6d538408234de9877535f4bdf46ef4
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spelling	oai:doaj.org-article:fa6d538408234de9877535f4bdf46ef42021-12-02T04:11:25ZOperationalizing a frailty index using routine blood and urine tests1178-1998https://doaj.org/article/fa6d538408234de9877535f4bdf46ef42017-06-01T00:00:00Zhttps://www.dovepress.com/operationalizing-a-frailty-index-using-routine-blood-and-urine-tests-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Martin 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, mortalityRitt MJäger JRitt JISieber CCGaßmann KGDove Medical PressarticleOlder peoplehospitalgeriatric wardsfrailtyrisk stratificationmortalityGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 12, Pp 1029-1040 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	Older people hospital geriatric wards frailty risk stratification mortality Geriatrics RC952-954.6
spellingShingle	Older people hospital geriatric wards frailty risk stratification mortality Geriatrics RC952-954.6 Ritt M Jäger J Ritt JI Sieber CC Gaßmann KG Operationalizing a frailty index using routine blood and urine tests
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
format	article
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
title	Operationalizing a frailty index using routine blood and urine tests
title_short	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_sort	operationalizing a frailty index using routine blood and urine tests
publisher	Dove Medical Press
publishDate	2017
url	https://doaj.org/article/fa6d538408234de9877535f4bdf46ef4
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Operationalizing a frailty index using routine blood and urine tests

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