19 Modified fraility index as predictor of outcome for patients implanted with cardiac resynchronisation therapy
Notice bibliographique
Résumé
Introduction Frailty is a multidimensional syndrome, contributing significantly to the morbidity and mortality of elderly patients. With an increase in average life expectancy, there are a growing number of frail individuals with multiple co-morbidities and cardiac failure. Although multiple studies have shown that in selected patients cardiac resynchronisation therapy (CRT) improves morbidity and mortality, the role of frailty has not been rigorously evaluated in these individuals. There are no current risk scores for frailty to help refine the predicted impact of CRT on survival in elderly patients. Study aim and basic methods The focus of our study was to develop and review the role of an easy-to -use frailty index as a predictor of outcome in patients being considered for CRT and suggest ways in which frailty assessment could be incorporated into clinical practice. This was a retrospective study of 265 patients implanted with CRT from 2011 to 2015. Data was collected from patient electronic records and follow-up visits. The median follow-up duration was 2.2 (1.2–3.3) years. A modified frailty index was formulated using the Canadian Study of Health and Ageing. The modified frailty index was based on 9 of the potential 70 Canadian Study of Health and Ageing clinical deficits. These variables were chosen based on the likelihood of being recorded in the electronic records bearing in mind the practical future application of the frailty index in a clinical setting. Each deficit was given 1 point except age>75 years (given 2 points). The clinical parameters used and their prevalence in our study population is shown in figure 1. Data were analysed using SPSS and Microsoft excel using Chi square test, survival analysis and ROC analysis. Results 1. In patients implanted with CRT, mortality was found to be higher in patients with a greater frailty index. (p value 0.00003) (Image 1) 2. Mean modified frailty index in those who died was higher (4.4; SD 1.5) than in those who lived (3.1; SD 1.5) 3. In ROC analysis, frailty index >2 was a significant predictor of mortality in our subgroup of patients (sensitivity 97.7%, AUC 0.73, 95% CI=0.14–0.32, p<0.0001) (Image 2) Abstract 19 Figure 3 Conclusion In patients implanted with CRT mortality was found to be significantly greater in more frail patients, represented by a higher modified frailty index. Therefore the modified frailty index may be a useful tool in predicting mortality, helping to guide patient and family expectations when considering device therapy. Abstract 19 Figure 1 Modified Frailty Index Clinical parameters and prevalence in our study population (Potential for a maximum and minimum modified frailty index of 11 and 0) Abstract 19 Figure 2
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».