1. A comparison of frailty indexes based on a comprehensive geriatric assessment for the prediction of adverse outcomes
- Author
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C. Schwarz, K. G. Gassmann, Cornel C. Sieber, Martin Ritt, K. H. Rádi, and L. C. Bollheimer
- Subjects
Male ,Gerontology ,endocrine system ,medicine.medical_specialty ,Adverse outcomes ,Hospitalized patients ,Frail Elderly ,Medicine (miscellaneous) ,Comorbidity ,Cohort Studies ,Continuous variable ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Humans ,Medicine ,Prospective Studies ,030212 general & internal medicine ,Mortality ,General hospital ,Prospective cohort study ,Geriatric Assessment ,Categorical variable ,Aged ,Aged, 80 and over ,Nutrition and Dietetics ,business.industry ,Geriatric assessment ,Length of Stay ,Prognosis ,ROC Curve ,Female ,Geriatrics and Gerontology ,business ,Hospital stay ,030217 neurology & neurosurgery - Abstract
To compare the ability of different frailty indexes based on a standardized comprehensive geriatric assessment (FI-CGAs) for predicting adverse outcomes.Prospective cohort study. Geriatric wards of a general hospital.307 hospitalized patients ≥ 65 years.The FI-CGA-10D (potential health deficits in ten functional domains), the FI-CGA-10D+CM (aforementioned potential health deficits and co-morbidity burden) and the FI-CGA-MIHD (multiple, individual potential health deficits, including functional deficits, co-morbid diseases, amongst others) were assessed at baseline during the patients` hospital stay. The FI-CGAs were analyzed as categorical (according to a FI-CGA scoreand ≥ 0.25) and continuous variables. Patients were followed up over 6 months.The FI-CGA-10D, FI-CGA-10+CM and the FI-CGA-MIHD predicted 6-month mortality when expressed as categorical (area under the receiver operating characteristic curve (AUC): AUC = 0.611, AUC = 0.637, AUC = 0.616, all p0.050, respectively) or continuous variables (AUC = 0.769, AUC = 0.837, AUC = 0.834, all p0.001, respectively). AUC comparisons showed that all three FI-CGAs exhibited a comparable ability to predict 6-month mortality when the FI-CGAs were expressed as categorical variables (all p0.200) and the FI-CGA-10D+CM and the FI-CGA-MIHD showed a better ability to predict 6-month mortality than the FI-CGA-10D, when the FI-CGAs were expressed as continuous variables (p0.001 and p = 0.007, respectively). None of the FI-CGAs predicted any of the other outcomes, i.e., unplanned re-admission to hospital and a fall during follow-up, irrespective of whether the FI-CGAs were expressed as categorical or continuous variables (all p ≥ 0.050).The more complex FI-CGAs, i.e., the FI-CGA-10D+CM and the FI-CGA-MIHD, revealed better ability to predict 6 month mortality than the more simple FI-CGA, i.e., the FI-CGA-10D.
- Published
- 2015
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