使用 FRAIL 量表进行虚弱筛查：与表型标准的比较。
Screening for Frailty With the FRAIL Scale: A Comparison With the Phenotype Criteria.
机构信息
Division of Geriatrics, Department of Internal Medicine, Faculty of Medicine, University of São Paulo (USP), São Paulo, Brazil; Institute and Department of Psychiatry, Faculty of Medicine, USP, São Paulo, Brazil; Department of Internal Medicine, Faculty of Medicine of Jundiaí, Jundiaí, Brazil.
Institute and Department of Psychiatry, Faculty of Medicine, USP, São Paulo, Brazil.
出版信息
J Am Med Dir Assoc. 2017 Jul 1;18(7):592-596. doi: 10.1016/j.jamda.2017.01.009. Epub 2017 Mar 6.
BACKGROUND
Reliable and valid frailty screening instruments are lacking. The aim of the present study was to compare the diagnostic properties of the FRAIL-BR with Fried's frailty phenotype (CHS), which has not been done.
METHODS
Cross-sectional observational study of 124 older adults aged 60 or older from 2 university-based geriatric outpatient units in the state of São Paulo, Brazil. In ROC analyses, we evaluated different cutoff points and AUC areas of the FRAIL-BR compared with the CHS criteria. Also, components of both diagnostic strategies had head-to-head comparisons whenever possible.
RESULTS
The sample was composed mostly of overweight (mean BMI = 29.5 kg/m) women (83%) with mean age of 78.6 (±7.1) years. Prevalence of frailty varied according to the FRAIL-BR (23.3%) and the CHS criteria (14.5%) (P = .04). A cutoff of 3 points in the FRAIL-BR presented a sensitivity of 28% and specificity of 90% (P = .049). A cutoff of 2 points resulted in a sensitivity of 54% and specificity of 73% (P = .01). Comparisons of 4 FRAIL-BR items (ie, weight loss, aerobic capacity, fatigue, and physical resistance) to the respective CHS components showed an independent diagnostic property of all measures, with the exception for weight loss.
CONCLUSION
The FRAIL scale can be used as a screening instrument for frailty (time and cost-effective).
背景
目前缺乏可靠且有效的衰弱筛查工具。本研究旨在比较 FRAIL-BR 与 Fried 衰弱表型（CHS）的诊断特性，而这在以前尚未进行过。
方法
这是一项在巴西圣保罗州 2 所大学老年门诊单位的 124 名 60 岁及以上老年人中进行的横断面观察性研究。在 ROC 分析中，我们评估了 FRAIL-BR 与 CHS 标准相比的不同截断点和 AUC 面积。此外，只要有可能，两种诊断策略的组成部分都进行了直接比较。
结果
该样本主要由超重（平均 BMI 为 29.5 kg/m）的女性（83%）组成，平均年龄为 78.6（±7.1）岁。根据 FRAIL-BR（23.3%）和 CHS 标准（14.5%），衰弱的患病率有所不同（P=0.04）。FRAIL-BR 的截断值为 3 分时，灵敏度为 28%，特异性为 90%（P=0.049）。截断值为 2 分时，灵敏度为 54%，特异性为 73%（P=0.01）。对 FRAIL-BR 的 4 项指标（即体重减轻、有氧运动能力、疲劳和身体抵抗力）与相应的 CHS 成分进行比较显示，除体重减轻外，所有指标均具有独立的诊断特性。
结论
FRAIL 量表可作为一种用于筛查衰弱的工具（省时且具有成本效益）。
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