Tardieu Émilie, Mahmoudi Rachid, Novella Jean-Luc, Oubaya Nadia, Blanchard François, Jolly Damien, Dramé Moustapha
Service de gériatrie et médecine interne, CHU de Reims, Hôpital Maison Blanche, Reims, France.
Service de gériatrie et médecine interne, CHU de Reims, Hôpital Maison Blanche, Reims, France, Université de Reims Champagne-Ardenne, Faculté de Médicine, EA 3797, Reims, France.
Geriatr Psychol Neuropsychiatr Vieil. 2016 Mar;14(1):49-55. doi: 10.1684/pnv.2016.0592.
The aim of the study was to achieve the external validation of the SAGA instrument on the SAFES cohort. This was a prospective longitudinal multicentre cohort study, including patients aged 75 years or over, hospitalized in a short stay medical ward via emergency department. A comprehensive geriatric assessment was implemented. The psychometric validation enabled the study of feasibility, internal consistency, convergent, discriminant, and predictive validity of the instrument. The 1 306 patients of the cohort was 85±6 years, with a majority of women (65%). The completion rate of the SEGA instrument was 94%. Internal consistency was good (Cronbach alpha coefficient=0.7). Convergent validity was poor: Donini instrument (kappa=0.18; IC 95%=0.13-0.23), Rockwood instrument (kappa=0.04; IC 95%=0.02-0.06), and Winograd instrument (kappa=0.04; IC 95%=0.01-0.07). The ability of the instrument to discriminate clinically different groups was good. The SEGA instrument predicted well one-year mortality as well as one-year institution admission. Despite poor convergent validity (which is classic with frailty tools, SEGA instrument has satisfactory metrological properties, allowing its use in emergency departments and immediate post-emergency circumstances.
本研究的目的是在SAFES队列中对SAGA工具进行外部验证。这是一项前瞻性纵向多中心队列研究，纳入年龄在75岁及以上、通过急诊科入住短期医疗病房的患者。实施了全面的老年综合评估。心理测量学验证对该工具的可行性、内部一致性、收敛性、区分性和预测效度进行了研究。该队列的1306名患者年龄为85±6岁，大多数为女性（65%）。SAGA工具的完成率为94%。内部一致性良好（克朗巴哈α系数=0.7）。收敛效度较差：多尼尼工具（kappa=0.18；95%置信区间=0.13-0.23）、罗克伍德工具（kappa=0.04；95%置信区间=0.02-0.06）和维诺格拉德工具（kappa=0.04；95%置信区间=0.01-0.07）。该工具区分临床不同组别的能力良好。SAGA工具对一年死亡率和一年机构入院率的预测效果良好。尽管收敛效度较差（这在虚弱评估工具中很常见），但SAGA工具具有令人满意的计量学特性，可用于急诊科及急诊后即刻情况。
