Mailliez Aurélie, Leroy Maxime, Génin Michael, Drumez Elodie, Puisieux François, Beuscart Jean-Baptiste, Bautmans Ivan, Balayé Pierre, Boulanger Eric
Department of Geriatrics, CHU Lille, Lille, France.
Univ. Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1167-RID-AGE-Facteurs de Risque et Déterminants Moléculaires des Maladies Liées au Vieillissement, Lille, France.
BMJ Public Health. 2025 Mar 23;3(1):e001941. doi: 10.1136/bmjph-2024-001941. eCollection 2025 Jan.
To easily detect frailty in a timely fashion, enabling targeted interventions and appropriate monitoring, will be a major worldwide public health and economic challenge as the proportion of older people increases in the population. Based on a review and meta-analysis showing that C-reactive protein (CRP), haemoglobin, albumin and vitamin D are associated with frailty, we aimed to develop and validate a biological score using these biomarkers for the detection of frailty.
We conducted a retrospective, cross-sectional, monocentric study using the electronic healthcare database of Lille University Hospital, France.
Inclusion criteria were patients aged 50 and over, being hospitalised at Lille University Hospital between 1 January 2008 and 31 December 2021. We identified patients whose CRP, haemoglobin, albumin and vitamin D levels were measured. We selected patients whose assays fell within normal thresholds, outside acute clinical situations.
To assess frailty, we used a scale adapted to electronic healthcare database, called the Hospital Frailty Risk Score. To develop and validate the predictive frailty score, the whole population was divided into a development and a validation cohort.
26 554 patients were included, of which 17 702 were in the development cohort and 8852 in the validation cohort. Based on the results of the multivariate analysis, we developed an equation combining CRP, haemoglobin, albumin and vitamin D with age and sex to obtain a score referred to as the bFRAil (biological FRAilty) score. Within the validation cohort, the area under the curve for this score is 0.78 (0.77-0.80) and the negative predictive value is 83.7%.
This study has made it possible, for the first time, to develop and validate in a hospital setting a biological score called bFRAil score based on simple, easily measurable biomarkers for identifying frail patients in daily medical practice. Further studies are needed to validate its use.
随着老年人口在总人口中的比例增加，如何及时轻松地检测出衰弱，从而进行有针对性的干预和适当的监测，将成为一项重大的全球公共卫生和经济挑战。基于一项综述和荟萃分析表明C反应蛋白（CRP）、血红蛋白、白蛋白和维生素D与衰弱有关，我们旨在开发并验证一种使用这些生物标志物检测衰弱的生物学评分。
我们使用法国里尔大学医院的电子医疗数据库进行了一项回顾性、横断面、单中心研究。
纳入标准为年龄在50岁及以上、于2008年1月1日至2021年12月31日期间在里尔大学医院住院的患者。我们确定了那些CRP、血红蛋白、白蛋白和维生素D水平被测量的患者。我们选择了检测结果在正常阈值范围内、非急性临床情况的患者。
为了评估衰弱，我们使用了一种适用于电子医疗数据库的量表，称为医院衰弱风险评分。为了开发和验证预测性衰弱评分，将整个人群分为一个开发队列和一个验证队列。
共纳入26554名患者，其中17702名在开发队列，8852名在验证队列。基于多变量分析的结果，我们开发了一个将CRP、血红蛋白、白蛋白、维生素D与年龄和性别相结合的方程，以获得一个称为bFRAil（生物学衰弱）评分的分数。在验证队列中，该评分的曲线下面积为0.78（0.77 - 0.80），阴性预测值为83.7%。
本研究首次在医院环境中开发并验证了一种基于简单、易于测量的生物标志物的生物学评分，即bFRAil评分，用于在日常医疗实践中识别衰弱患者。需要进一步研究以验证其用途。
