Kenig Jakub, Richter Piotr, Zychiewicz Beata, Olszewska Urszula
Pol Przegl Chir. 2014 Mar;86(3):126-31. doi: 10.2478/pjs-2014-0024.
The Vulnerable Elders Survey (VES-13) is a simple function based frailty screening tool that can be also administered by the nonclinical personnel within 5 minutes and has been validated in the out- and in patient clinic and acute medical care settings. The aim of the study was to validate the accuracy of the VES-13 screening method for predicting the frailty syndrome based on a CGA in polish surgical patients.
We included prospectively 106 consecutive patients ≥65, that qualify for abdominal surgery (both due to oncological and benign reasons), at the tertiary referral hospital.We evaluated the diagnostic performance of VES-13 score comparing to the results from the CGA, accepted as the gold standard for identifying at risk frail elderly patients.
The prevalence of frailty as diagnosed by CGA was 59.4%. There was significantly higher number of frail patients in the oncological group (78% vs. 31%; p<0.01). According to the frailty screening methods, the frailty prevalence was 45.3%. The VES-13 score had a 60% sensitivity and 78% specificity in detecting frailty syndrome. The positive and negative predictive value was 81% and 57%, respectively. The overall predictive capacity was intermediate (AUC=0.69) CONCLUSIONS: At present, the VES-13 screening tool for older patients cannot replace the comprehensive geriatric assessment; this is due to the insufficient discriminative power to select patients for further assessment. It might be helpful in a busy clinical practice and in facilities that do not have trained personal for geriatric assessment.
脆弱老年人调查（VES - 13）是一种基于功能的简单衰弱筛查工具，非临床人员也可在5分钟内进行操作，并且已在门诊、住院部及急性医疗护理环境中得到验证。本研究的目的是基于波兰外科患者的综合老年评估，验证VES - 13筛查方法预测衰弱综合征的准确性。
我们前瞻性纳入了一家三级转诊医院中106例连续的≥65岁且符合腹部手术条件（包括肿瘤性和良性原因）的患者。我们将VES - 13评分的诊断性能与综合老年评估的结果进行比较，综合老年评估被视为识别有衰弱风险老年患者的金标准。
综合老年评估诊断出的衰弱患病率为59.4%。肿瘤组中衰弱患者数量显著更多（78%对31%；p<0.01）。根据衰弱筛查方法，衰弱患病率为45.3%。VES - 13评分检测衰弱综合征的敏感性为60%，特异性为78%。阳性预测值和阴性预测值分别为81%和57%。总体预测能力中等（AUC = 0.69）结论：目前，针对老年患者的VES - 13筛查工具不能替代全面的老年评估；这是由于其选择患者进行进一步评估的鉴别能力不足。它可能在繁忙的临床实践以及没有经过老年评估培训人员的机构中有所帮助。
