A frailty index based on laboratory deficits in community-dwelling men predicted their risk of adverse health outcomes
A frailty index based on laboratory deficits in community-dwelling men predicted their risk of adverse health outcomes
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DOI：
10.1093/ageing/afw054
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发表时间：
2016-07-01
期刊：
影响因子：
6.7
通讯作者：
Rockwood, Kenneth
中科院分区：
文献类型：
--
作者：
Blodgett, Joanna M.;Theou, Olga;Rockwood, Kenneth
背景：异常的实验室检查结果随着年龄的增长而积累，并且在临床上几乎检测不到健康缺陷的人群中很常见。与临床脆弱指数（FI-Clin）相比，完全基于普通生理和实验室测试（FI-Lab）的脆弱指数（FI）可能具有实用和科学的优势。目的：比较FI-Lab与FI-Clin，并评估其与死亡率和其他不良健康结果的个体和组合关系。设计和受试者：对基线时年龄在40-79岁的社区居住男性进行的八中心纵向欧洲男性老龄化研究（EMAS）的二次分析。随访评估发生4.4 +/- 0.3（平均值+/- SD）years later.Methods：我们构建了一个23项FI使用常见的实验室检查，血压和脉搏（FI实验室），比较它与以前验证的39项FI使用自我报告和性能为基础的措施（FI临床），最后结合两个FI创建一个62项FI组合。结果是全因死亡率，机构化，医生就诊，药物使用，自我报告的健康，福尔斯和frauds.Results：平均FI-实验室评分为0.28 +/- 0.11，FI-临床为0.13 +/- 0.11和FI-组合为0.19 +/- 0.09。校正模型表明，各FI与死亡率[HR（CI）FI-实验室：1.04（1.03-1.06）; FI-临床：1.05（1.04-1.06）; FI-组合：1.07（1.06-1.09）]、住院、医生访视、药物使用、自我报告的健康状况和福尔斯相关。在一个模型与FI-临床相结合，FI-实验室仍然独立与死亡率，制度化，医生就诊，药物使用和自我报告health.Conclusions：FI-实验室检测到的不良健康后果的风险增加，单独和结合临床FI;进一步评估的可行性FI-实验室作为一个脆弱的筛选工具，在医院护理设置是必要的。
Background: abnormal laboratory test results accumulate with age and can be common in people with few clinically detectable health deficits. A frailty index (FI) based entirely on common physiological and laboratory tests (FI-Lab) might offer pragmatic and scientific advantages compared with a clinical FI (FI-Clin).Objectives: to compare the FI-Lab with the FI-Clin and to assess their individual and combined relationships with mortality and other adverse health outcomes.Design and subjects: secondary analysis of the eight-centre, longitudinal European Male Ageing Study (EMAS) of community-dwelling men aged 40-79 at baseline. Follow-up assessment occurred 4.4 +/- 0.3 (mean +/- SD) years later.Methods: we constructed a 23-item FI using common laboratory tests, blood pressure and pulse (FI-Lab), compared it with a previously validated 39-item FI using self-report and performance-based measures (FI-Clin) and finally combined both FIs to create a 62-item FI-Combined. Outcomes were all-cause mortality, institutionalisation, doctor visits, medication use, self-reported health, falls and fractures.Results: the mean FI-Lab score was 0.28 +/- 0.11, the FI-Clin was 0.13 +/- 0.11 and FI-Combined was 0.19 +/- 0.09. Age-adjusted models demonstrated that each FI was associated with mortality [HR (CI) FI-Lab: 1.04 (1.03-1.06); FI-Clin: 1.05 (1.04-1.06); FI-Combined: 1.07 (1.06-1.09)], institutionalisation, doctor visits, medication use, self-reported health and falls. Combined in a model with FI-Clin, the FI-Lab remained independently associated with mortality, institutionalisation, doctor visits, medication use and self-reported health.Conclusions: the FI-Lab detected an increased risk of adverse health outcomes alone and in combination with a clinical FI; further evaluation of the feasibility of the FI-Lab as a frailty screening tool within hospital care settings is needed.