153 Agreement among frailty assessment tools and their association with quality of life in older patients with heart failure: a comparison of four instruments
Notice bibliographique
Résumé
<h3>Introduction</h3> Frailty is highly prevalent in older patients with heart failure (HF) and is associated with poor clinical outcomes. Many tools are available for assessing frailty, however, very few studies have simultaneously evaluated different frailty tools and their relation to quality of life (QoL) within the same cohort of patients. We studied the agreement between 4 commonly used frailty tools and their association with QoL and functional dependence amongst older patients with HF. <h3>Methods</h3> We recruited older adults (aged ≥ 65) with HF from a hospital-based HF clinic and assessed their frailty using 4 tools: Clinical Frailty Scale (CFS), Fried Frailty Phenotype (FP), Short Physical Performance Battery (SPPB) and Edmonton Frail Scale (EFS). Patients were classified as frail and non-frail according to cut-offs specified by each instrument. Functional dependence and QoL were assessed using Barthel Index (BI) and Kansas City Cardiomyopathy Questionnaire (KCCQ-12), respectively. Kappa statistics was used to assess the level of agreement between the frailty tools. <h3>Results</h3> We studied 150 participants [median age: 80 (range 65–94) years, 65% male]. Thirty-eight percent had HF with reduced ejection fraction; One fifth had NYHA III/IV symptoms; median NT-proBNP 2137 ng/L (IQR = 1120–5028). The SPPB model identified the highest proportion of patients as frail (69%), followed by CFS (67%), FP (57%) and EFS (47%) (table 1). Forty-five patients (30%) were classified as frail by all 4 tools (figure 1). There was moderate agreement between SPPB vs CFS (&kgreen; = 0.49) and SPPB vs FP (&kgreen; = 0.43) and fair agreement between FP vs CFS (&kgreen; = 0.29), FP vs EFS (&kgreen; = 0.25), CFS vs EFS (&kgreen; = 0.27) and SPPB vs EFS (&kgreen; = 0.220), all p < 0.001 (table 2). Of the frailty tools, CFS had the strongest correlation with BI (r = -0.703, p < 0.001), whilst EFS had the strongest correlation with KCCQ-12 (r = -0.627, p < 0.001). Worse frailty status determined by any frailty tool was significantly associated with poorer QoL and functional dependence after adjusting for age and NYHA class. <h3>Conclusion</h3> SPPB had moderate agreement with FP and CFS while EFS had low agreement with other frailty tools. Frailty was significantly associated with functional dependence and QoL in older patients with HF. Our observations have implications for the application of clinical frailty tools in clinical practice and in research. <h3>Conflict of Interest</h3> None
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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 | 0,001 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 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 ».