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Frail-VIG index: a concise frailty evaluation tool for rapid geriatric assessment
BACKGROUND: Demographic changes have led to an increase in the number of elderly frail persons and, consequently, systematic geriatric assessment is more important than ever. Frailty Indexes (FI) may be particularly useful to discriminate between various degrees of frailty but are not routinely asse...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5787254/ https://www.ncbi.nlm.nih.gov/pubmed/29373968 http://dx.doi.org/10.1186/s12877-018-0718-2 |
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author | Amblàs-Novellas, Jordi Martori, Joan Carles Espaulella, Joan Oller, Ramon Molist-Brunet, Núria Inzitari, Marco Romero-Ortuno, Roman |
author_facet | Amblàs-Novellas, Jordi Martori, Joan Carles Espaulella, Joan Oller, Ramon Molist-Brunet, Núria Inzitari, Marco Romero-Ortuno, Roman |
author_sort | Amblàs-Novellas, Jordi |
collection | PubMed |
description | BACKGROUND: Demographic changes have led to an increase in the number of elderly frail persons and, consequently, systematic geriatric assessment is more important than ever. Frailty Indexes (FI) may be particularly useful to discriminate between various degrees of frailty but are not routinely assessed due, at least in part, to the large number of deficits assessed (from 30 to 70). Therefore, we have developed a new, more concise FI for rapid geriatric assessment (RGA)—the Frail-VIG index (“VIG” is the Spanish/Catalan abbreviation for Comprehensive Geriatric Assessment), which contains 22 simple questions that assess 25 different deficits. Here we describe this FI and report its ability to predict mortality at 24 months. METHODS: Prospective, observational, longitudinal study of geriatric patients followed for 24 months or until death. The study participants were patients (n = 590) admitted to the Acute Geriatric Unit at the at the University Hospital of Vic (Barcelona) during the year 2014. Participants were classified into one of seven groups based on their Frail-VIG score (0–0.15; 0.16–0.25; 0.26–0.35; 0.36–0.45; 0.46–0.55; 0.56–0.65; and 0.66–1). Survival curves for these groups were compared using the log-rank test. ROC curves were used to assess the index’s capacity to predict mortality at 24 months. RESULTS: Mean (standard deviation) patient age was 86.4 (5.6) years. The 24-month mortality rate was 57.3% for the whole sample. Significant between-group (deceased vs. living) differences (p < 0.05) were observed for most index variables. Survival curves for the seven Frail-VIG groups differed significantly (X(2) = 433.4, p < 0.001), with an area under the ROC curve (confidence interval) of 0.90 (0.88–0.92) at 12 months and 0.85 (0.82–0.88) at 24 months. Administration time for the Frail-VIG index ranged from 5 to 10 min. CONCLUSIONS: The Frail-VIG index, which requires less time to administer than previously validated FIs, presents a good discriminative capacity for the degree of frailty and a high predictive capacity for mortality in the present cohort. Although more research is needed to confirm the validity of this instrument in other populations and settings, the Frail-VIG may provide clinicians with a RGA method and also a reliable tool to assess frailty in routine practice. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12877-018-0718-2) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-5787254 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-57872542018-02-08 Frail-VIG index: a concise frailty evaluation tool for rapid geriatric assessment Amblàs-Novellas, Jordi Martori, Joan Carles Espaulella, Joan Oller, Ramon Molist-Brunet, Núria Inzitari, Marco Romero-Ortuno, Roman BMC Geriatr Research Article BACKGROUND: Demographic changes have led to an increase in the number of elderly frail persons and, consequently, systematic geriatric assessment is more important than ever. Frailty Indexes (FI) may be particularly useful to discriminate between various degrees of frailty but are not routinely assessed due, at least in part, to the large number of deficits assessed (from 30 to 70). Therefore, we have developed a new, more concise FI for rapid geriatric assessment (RGA)—the Frail-VIG index (“VIG” is the Spanish/Catalan abbreviation for Comprehensive Geriatric Assessment), which contains 22 simple questions that assess 25 different deficits. Here we describe this FI and report its ability to predict mortality at 24 months. METHODS: Prospective, observational, longitudinal study of geriatric patients followed for 24 months or until death. The study participants were patients (n = 590) admitted to the Acute Geriatric Unit at the at the University Hospital of Vic (Barcelona) during the year 2014. Participants were classified into one of seven groups based on their Frail-VIG score (0–0.15; 0.16–0.25; 0.26–0.35; 0.36–0.45; 0.46–0.55; 0.56–0.65; and 0.66–1). Survival curves for these groups were compared using the log-rank test. ROC curves were used to assess the index’s capacity to predict mortality at 24 months. RESULTS: Mean (standard deviation) patient age was 86.4 (5.6) years. The 24-month mortality rate was 57.3% for the whole sample. Significant between-group (deceased vs. living) differences (p < 0.05) were observed for most index variables. Survival curves for the seven Frail-VIG groups differed significantly (X(2) = 433.4, p < 0.001), with an area under the ROC curve (confidence interval) of 0.90 (0.88–0.92) at 12 months and 0.85 (0.82–0.88) at 24 months. Administration time for the Frail-VIG index ranged from 5 to 10 min. CONCLUSIONS: The Frail-VIG index, which requires less time to administer than previously validated FIs, presents a good discriminative capacity for the degree of frailty and a high predictive capacity for mortality in the present cohort. Although more research is needed to confirm the validity of this instrument in other populations and settings, the Frail-VIG may provide clinicians with a RGA method and also a reliable tool to assess frailty in routine practice. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12877-018-0718-2) contains supplementary material, which is available to authorized users. BioMed Central 2018-01-26 /pmc/articles/PMC5787254/ /pubmed/29373968 http://dx.doi.org/10.1186/s12877-018-0718-2 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Amblàs-Novellas, Jordi Martori, Joan Carles Espaulella, Joan Oller, Ramon Molist-Brunet, Núria Inzitari, Marco Romero-Ortuno, Roman Frail-VIG index: a concise frailty evaluation tool for rapid geriatric assessment |
title | Frail-VIG index: a concise frailty evaluation tool for rapid geriatric assessment |
title_full | Frail-VIG index: a concise frailty evaluation tool for rapid geriatric assessment |
title_fullStr | Frail-VIG index: a concise frailty evaluation tool for rapid geriatric assessment |
title_full_unstemmed | Frail-VIG index: a concise frailty evaluation tool for rapid geriatric assessment |
title_short | Frail-VIG index: a concise frailty evaluation tool for rapid geriatric assessment |
title_sort | frail-vig index: a concise frailty evaluation tool for rapid geriatric assessment |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5787254/ https://www.ncbi.nlm.nih.gov/pubmed/29373968 http://dx.doi.org/10.1186/s12877-018-0718-2 |
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