Journal
JOURNAL OF RHEUMATOLOGY
Volume 47, Issue 1, Pages 72-81Publisher
J RHEUMATOL PUBL CO
DOI: 10.3899/jrheum.181338
Keywords
SYSTEMIC LUPUS ERYTHEMATOSUS; OUTCOME ASSESSMENT; COHORT STUDIES
Categories
Funding
- Nova Scotia Health Authority Research Fund
- Republic of Korea [NRF-2017M3A9B4050335]
- Lupus UK
- NIHR/Wellcome Trust Clinical Research Facility
- Singer Family Fund for Lupus Research
- Arthritis Society Chair in Rheumatic Diseases at the University of Calgary
- tier 1 Canada Research Chair on Systemic Autoimmune Rheumatic Diseases at Universite Laval
- Arthritis Research UK
- NIHR Manchester Biomedical Centre
- NIHR/Wellcome Trust Manchester Clinical Research Facility
- NIHR University College London Hospitals Biomedical Research Center
- US National Institutes of Health (NIH) [AR43727, 69572]
- NIH [RR00046, 5UL1TR001422-02, UL-1RR-025741, K24-AR-02318, P60AR064464]
- Department of Education, Universities and Research of the Basque Government
- Danish Rheumatism Association [A3865]
- Novo Nordisk Foundation [A05990]
- Canadian Institutes of Health Research [MOP-88526]
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Objective. To construct a Frailty Index (FI) as a measure of vulnerability to adverse outcomes among patients with systemic lupus erythematosus (SLE), using data from the Systemic Lupus International Collaborating Clinics (SLICC) inception cohort. Methods. The SLICC inception cohort consists of recently diagnosed patients with SLE followed annually with clinical and laboratory assessments. For this analysis, the baseline visit was defined as the first study visit at which sufficient information was available for construction of an FI. Following a standard procedure, variables from the SLICC database were evaluated as potential health deficits. Selected health deficits were then used to generate a SLICC-FI. The prevalence of frailty in the baseline dataset was evaluated using established cutpoints for FI values. Results. The 1683 patients with SLE (92.1% of the overall cohort) eligible for inclusion in the baseline dataset were mostly female (89%) with mean (SD) age 35.7 (13.4) years and mean (SD) disease duration 18.8 (15.7) months at baseline. Of 222 variables, 48 met criteria for inclusion in the SLICC-FI. Mean (SD) SLICC-FI was 0.17 (0.08) with a range from 0 to 0.51. At baseline, 27.1% (95% CI 25.0-29.2) of patients were classified as frail, based on SLICC-FI values > 0.21. Conclusion. The SLICC inception cohort permits feasible construction of an FI for use in patients with SLE. Even in a relatively young cohort of patients with SLE, frailty was common. The SLICC-FI may be a useful tool for identifying patients with SLE who are most vulnerable to adverse outcomes, but validation of this index is required prior to its use.
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