4.7 Article

Validating the agreement between the geriatric trauma frailty index and four published frailty scores in the Chinese geriatric trauma population

Journal

BMC GERIATRICS
Volume 22, Issue 1, Pages -

Publisher

BMC
DOI: 10.1186/s12877-022-02819-9

Keywords

Frailty scores; Geriatric; Trauma; Elderly population; Agreement

Funding

  1. National Natural Science Foundation of China [71774167, 71774166, 71804186]
  2. Major Project of the National Natural Science Foundation of China [71233008]
  3. Great Project of the National Natural Science Foundation of China [91224005]
  4. Shanghai Pujiang Program [18PJC116]
  5. Shanghai Three-year Action Plan for Strengthening the Construction of Public Health System (2020-2022) [GWV-10.2-XD34]
  6. Research and Application Demonstration of Active Health Intelligent Care Platform for the Elderly Based on Blockchain [2020YFC2008700]

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This study aimed to compare the consistency of a constructed geriatric trauma frailty index with previously published indexes. The results showed that different frailty indexes have inconsistencies in evaluating the frailty status of patients and cannot be interchangeable.
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.

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