Ginanjar Eka, Rizka Aulia, Ayub Aulia Malik, Rinaldi Ikhwan, Gani Rino Alvani, Irawan Cosphiadi, Dwimartutie Noto
Division of Cardiovascular, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
Division of Geriatric, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
Acta Med Indones. 2025 Apr;57(2):200-211.
There is currently no gold standard for assessing frailty syndrome in older adults with heart failure. The Cardiovascular Health Study (CHS) is a reference standard for evaluating frailty in older adults with heart failure. Still, it requires a dynamometer and a spacious space, rendering it impractical in daily practice. The INA-FRAIL and Study of Osteoporotic Fractures (SOF) Index can often be easy to use; however, it has not been evaluated for diagnostic performance on older adults with heart failure in Indonesia. This study aimed to assess the diagnostic performance of INA-FRAIL and SOF-Index in diagnosing frailty in older adults with heart failure.
This cross-sectional study evaluated the diagnostic performances of INA-FRAIL and SOF-Index compared to CHS as the gold standard in this study. The population was heart failure patients aged > 60 at Cipto Mangunkusumo Hospital.
Analysis from 81 samples shows the prevalence of frailty based on CHS (35.5%), INA-FRAIL (23.5%), and SOF-Index (8,6%). Diagnostic performance analysis of INA-FRAIL showed a sensitivity of 55,17% (95% CI 35.69-73.55), specificity 94.23% (95% CI 84.05- 98.79), and AUC 0.805 (95% CI 0.698-0.912). Diagnostic performance analysis of SOF showed 20,69% sensitivity (95% CI 7.99 - 39.72), 98.08% specificity (95% CI 89.74 - 99.95), and AUC 0.719 (95% CI 0.595 - 0.843).
INA-FRAIL and SOF-Index had a significant association with CHS. The cut-off point of INA-FRAIL ≥1 showed the highest sensitivity, while INA-FRAIL ≥2 showed the highest Youden index. The cut-off point of SOF ≥1 showed the highest sensitivity and the highest Youden index.
目前尚无评估老年心力衰竭患者衰弱综合征的金标准。心血管健康研究（CHS）是评估老年心力衰竭患者衰弱的参考标准。然而，它需要测力计和宽敞的空间，在日常实践中不实用。INA - FRAIL和骨质疏松性骨折研究（SOF）指数通常易于使用；但是，尚未在印度尼西亚对老年心力衰竭患者的诊断性能进行评估。本研究旨在评估INA - FRAIL和SOF指数在诊断老年心力衰竭患者衰弱方面的诊断性能。
本横断面研究评估了INA - FRAIL和SOF指数与作为本研究金标准的CHS相比的诊断性能。研究对象为雅加达中央医院年龄>60岁的心力衰竭患者。
对81份样本的分析显示，基于CHS的衰弱患病率为35.5%，基于INA - FRAIL的为23.5%，基于SOF指数的为8.6%。INA - FRAIL的诊断性能分析显示敏感性为55.17%（95%可信区间35.69 - 73.55），特异性为94.23%（95%可信区间84.05 - 98.79），曲线下面积（AUC）为0.805（95%可信区间0.698 - 0.912）。SOF的诊断性能分析显示敏感性为20.69%（95%可信区间7.99 - 39.72），特异性为98.08%（95%可信区间89.74 - 99.95），AUC为0.719（95%可信区间0.595 - 0.843）。
INA - FRAIL和SOF指数与CHS有显著关联。INA - FRAIL≥1的截断点显示出最高敏感性，而INA - FRAIL≥2显示出最高约登指数。SOF≥1的截断点显示出最高敏感性和约登指数。
