Author:
Zhao Fangjie,Tang Bihan,Liu Xu,Zhang Zhifeng,Zhang Lulu
Abstract
Abstract
Background
In the geriatric patient population, frailty significantly affects a patient’s prognostic outcome. This study aimed to compare the consistency of our constructed geriatric trauma frailty index with previously published indexes.
Methods
The geriatric trauma frailty index (GTFI) was compared with four previously published frailty indexes, i.e., the hospital frailty risk score (HFRS), Fried index, trauma-specific frailty index (TSFI), and 11-item modified frailty index (mFI) using the Bland-Altman method, intraclass correlation coefficient (ICC), and kappa consistency test. The indexes were calculated based on data collected from 101 questionnaires and medical records from 101 geriatric trauma patients at a tertiary hospital in Shanghai.
Results
Among the 101 geriatric trauma patients, 64 (63.4%) were women, with a mean age of 71.18 (SD = 9.89) years and mean length of stay (LOS) of 7.51 (SD = 3.89) days. The mean scores of GTFI score(≥ 1.3045 as frail), Fried index score(≥3 items as frail), TSFI score(≥ 4 as frail), and mFI (≥ 3 as frail),were 0.86 (SD = 1.51), 0.76 (SD = 1.07), 1.76 (SD = 1.96), and 1.29 (SD = 1.17). respectively. The GTFI score had good consistency with the HFRS (ICC: 0.716, 95% confidence interval [CI]: 0.596, 0.799, kappa: 0.608, 95% CI: 0.449, 0.766), fair consistency with the TSFI (ICC: 0.407, 95% CI: 0.227, 0.562, kappa: 0.460, 95% CI: 0.239, 0.672), and poor consistency with the mFI (ICC: 0.286, 95% CI: 0.097, 0.455, kappa: 0.305, 95% CI: 0.069, 0.525) and Fried index score (ICC: 0.256, 95% CI: 0.063, 0.426, kappa: 0.188, 95% CI: − 0.028, 0.408).
Conclusions
Different frailty indexes are based on different concepts of frailty and cannot be assumed to be interchangeable. There is still no gold standard for the current assessment methods of frailty, but it can be compared based on the understanding in terms of the concepts and measures used in each.
Publisher
Springer Science and Business Media LLC
Subject
Geriatrics and Gerontology
Reference15 articles.
1. Joseph B, Pandit V, Rhee P, Aziz H, Sadoun M, Wynne J, et al. Predicting hospital discharge disposition in geriatric trauma patients: is frailty the answer? J Trauma Acute Care Surg. 2014;76(1):196–200.
2. Polanczyk CA, Marcantonio E, Goldmanl L. Impact of age on perioperative complications and length of stay in patients undergoing noncardiac surgery. Acc Curr J Rev. 2001;134(8):637–43.
3. Guo D. China statistical Yearbook-2018. National Bureau of Statistics: Beijing; 2018.
4. Zhou Y, Zhu Z. Shanghai statistical Yearbook-2018. Shanghai: Shanghai Bureau of Statistics; Shanghai survey team of the National Bureau of. Statistics. 2018.
5. Government IbSMPs. The municipal government press conference introduces the implementation of the “Shanghai Three-year Action Plan for Strengthening the Construction of the Public Health System (2011–2013)”. 2014 [Available from: http://www.shanghai.gov.cn/nw2/nw2314/nw9819/nw9822/u21aw930341.html.