Chengdu University of Traditional Chinese Medicine, 1166 Liutai Avenue, Chengdu, 611137, China.
BMC Geriatr. 2023 Oct 2;23(1):617. doi: 10.1186/s12877-023-04243-z.
Pre-traumatic frailty in geriatric trauma patients has caught attention from emergency medical workers and the assessment of it thus become one of the important aspects of risk management. Several tools are available to identify frailty, but limited tools have been validated for geriatric trauma patients in China to assess pre-traumatic frailty.The aim of this study is to translate the Trauma-Specific Frailty Index(TSFI) into Chinese, and to evaluate the reliability and validity of the translated version in geriatric trauma patients.
A cross-sectional study was conducted. The TSFI was translated with using the Brislin model, that included forward and backward translation. A total of 184 geriatric trauma patients were recruited by a convenience sampling between October and December 2020 in Hospital of Chengdu University of Traditional Chinese Medicine, Sichuan. Using reliability or internal consistency tests assessed with Cronbach's alpha coefficient, split-half reliability and test-retest reliability. Content validity and construct validity analysis were both performed. Sensitivity, specificity and maximum Youden index(YI) were used to determine the optimal cut-off value. The screening performance was examined by Kappa value.
The total study population included 184 subjects, of which 8 participants were excluded, resulting in a study sample size of 176 elderly trauma patients (the completion rate was 95.7%). The Chinese version of Trauma-Specific Frailty Index(C-TSFI) have 15 items with 5 dimensions. Cronbach's alpha coefficient of the C-TSFI was 0.861, Cronbach's alpha coefficient of dimensions ranged from 0.837 to 0.875, the split-half reliability of the C-TSFI were 0.894 and 0.880 respectively, test-retest reliability ranged from 0.692 to 0.862. The correlation coefficient between items and the C-TSFI ranged from 0.439 to 0.761. The content validity index for items (I-CVI) of the C-TSFI scale was 0.86~1.00, and the scale of content validity index (S-CVI) was 0.93. The area under curve (AUC) of the C-TSFI was 0.932 (95%CI 0.904-0.96, P < 0.05), the maximum YI was 0.725, the sensitivity was 80.2%, the specificity was 92.3%, and the critical value was 0.31. Kappa value was 0.682 (P < 0.05).
The Chinese version of TSFI could be used as a general assessment tool in geriatric trauma patients, and both its reliability and validity have been demonstrated.
老年创伤患者创伤前虚弱已引起急诊医务人员的关注，因此对其进行评估已成为风险管理的重要方面之一。有几种工具可用于识别虚弱，但在中国，用于评估老年创伤患者创伤前虚弱的有限工具尚未得到验证。本研究旨在将创伤特异性虚弱指数（TSFI）翻译成中文，并评估其在老年创伤患者中的可靠性和有效性。
采用横断面研究。使用 Brislin 模型进行 TSFI 翻译，包括正向和反向翻译。2020 年 10 月至 12 月，采用便利抽样法在成都中医药大学附属医院招募了 184 名老年创伤患者。采用 Cronbach's alpha 系数、分半信度和重测信度进行可靠性或内部一致性测试。进行内容效度和结构效度分析。使用灵敏度、特异性和最大 Youden 指数（YI）来确定最佳截断值。通过 Kappa 值评估筛查性能。
总研究人群包括 184 名受试者，其中 8 名参与者被排除在外，因此研究样本量为 176 名老年创伤患者（完成率为 95.7%）。创伤特异性虚弱指数中文版（C-TSFI）有 15 个项目，分为 5 个维度。C-TSFI 的 Cronbach's alpha 系数为 0.861，维度的 Cronbach's alpha 系数范围为 0.837 至 0.875，C-TSFI 的分半信度分别为 0.894 和 0.880，重测信度范围为 0.692 至 0.862。项目与 C-TSFI 的相关系数范围为 0.439 至 0.761。C-TSFI 量表的项目内容效度指数（I-CVI）为 0.86~1.00，量表内容效度指数（S-CVI）为 0.93。C-TSFI 的曲线下面积（AUC）为 0.932（95%CI 0.904-0.96，P<0.05），最大 Youden 指数为 0.725，灵敏度为 80.2%，特异性为 92.3%，临界值为 0.31。Kappa 值为 0.682（P<0.05）。
中文版 TSFI 可作为老年创伤患者的一般评估工具，其可靠性和有效性已得到验证。
