Ritt M, Rádi K H, Schwarz C, Bollheimer L C, Sieber C C, Gaßmann K G
Priv.-Doz. Dr. med. Dr. med. univ. Martin Ritt, Department of Internal Medicine III (Medicine of Ageing), Geriatrics Centre Erlangen, Hospital of the Congregation of St. Francis Sisters of Vierzehnheiligen Rathsbergerstraße 57, D-91054 Erlangen, Germany, Tel: +49-(0)9131 822 3702, Fax: +49-(0)9131 822 3703, Email:
J Nutr Health Aging. 2016;20(7):760-7. doi: 10.1007/s12603-015-0644-3.
To compare the ability of different frailty indexes based on a standardized comprehensive geriatric assessment (FI-CGAs) for predicting adverse outcomes.
Prospective cohort study. Geriatric wards of a general hospital.
307 hospitalized patients ≥ 65 years.
The FI-CGA-10D (potential health deficits in ten functional domains), the FI-CGA-10D+CM (aforementioned potential health deficits and co-morbidity burden) and the FI-CGA-MIHD (multiple, individual potential health deficits, including functional deficits, co-morbid diseases, amongst others) were assessed at baseline during the patients` hospital stay. The FI-CGAs were analyzed as categorical (according to a FI-CGA score < and ≥ 0.25) and continuous variables. Patients were followed up over 6 months.
The FI-CGA-10D, FI-CGA-10+CM and the FI-CGA-MIHD predicted 6-month mortality when expressed as categorical (area under the receiver operating characteristic curve (AUC): AUC = 0.611, AUC = 0.637, AUC = 0.616, all p < 0.050, respectively) or continuous variables (AUC = 0.769, AUC = 0.837, AUC = 0.834, all p < 0.001, respectively). AUC comparisons showed that all three FI-CGAs exhibited a comparable ability to predict 6-month mortality when the FI-CGAs were expressed as categorical variables (all p > 0.200) and the FI-CGA-10D+CM and the FI-CGA-MIHD showed a better ability to predict 6-month mortality than the FI-CGA-10D, when the FI-CGAs were expressed as continuous variables (p < 0.001 and p = 0.007, respectively). None of the FI-CGAs predicted any of the other outcomes, i.e., unplanned re-admission to hospital and a fall during follow-up, irrespective of whether the FI-CGAs were expressed as categorical or continuous variables (all p ≥ 0.050).
The more complex FI-CGAs, i.e., the FI-CGA-10D+CM and the FI-CGA-MIHD, revealed better ability to predict 6 month mortality than the more simple FI-CGA, i.e., the FI-CGA-10D.
比较基于标准化综合老年评估的不同衰弱指数（FI-CGA）预测不良结局的能力。
前瞻性队列研究。一家综合医院的老年病房。
307名年龄≥65岁的住院患者。
在患者住院期间的基线时评估FI-CGA-10D（十个功能领域的潜在健康缺陷）、FI-CGA-10D+CM（上述潜在健康缺陷和共病负担）以及FI-CGA-MIHD（多种个体潜在健康缺陷，包括功能缺陷、共病疾病等）。FI-CGA被分析为分类变量（根据FI-CGA评分<和≥0.25）和连续变量。对患者进行6个月的随访。
当以分类变量表示时，FI-CGA-10D、FI-CGA-10+CM和FI-CGA-MIHD预测6个月死亡率（受试者工作特征曲线下面积（AUC）：AUC = 0.611、AUC = 0.637、AUC = 0.616，均p < 0.050）；当以连续变量表示时（AUC = 0.769、AUC = 0.837、AUC = 0.834，均p < 0.001）。AUC比较显示，当FI-CGA以分类变量表示时，所有三种FI-CGA预测6个月死亡率的能力相当（均p > 0.200）；当FI-CGA以连续变量表示时，FI-CGA-10D+CM和FI-CGA-MIHD预测6个月死亡率的能力优于FI-CGA-10D（分别为p < 0.001和p = 0.007）。无论FI-CGA是以分类变量还是连续变量表示，均无FI-CGA能预测任何其他结局，即计划外再次入院和随访期间跌倒（均p≥0.050）。
更复杂的FI-CGA，即FI-CGA-10D+CM和FI-CGA-MIHD，预测6个月死亡率的能力优于更简单的FI-CGA，即FI-CGA-10D。
