A comparison of frailty tools in haemodialysis: a prospective cohort study
Notice bibliographique
Résumé
Frailty is a syndrome of increased vulnerability to poor resolution of homeostasis after stressor event, and is associated with poor patient outcomes such as mortality, hospitalisation, and disability, including in haemodialysis recipients. It has, however, been subject to heterogenous reporting. Commonly cited frailty tools include the Frailty Phenotype (FP), Frailty Index (FI), Edmonton Frail Scale (EFS), and Clinical Frailty Scale (CFS). Each of these utilises different methodologies to determine frailty, and it is not known how they relate to one another in haemodialysis recipients. \n \nThe aims of this thesis are to explore frailty by each of these tools in prevalent haemodialysis recipients, both in relationship to one another, and their association with important patient-centred outcomes. \n \nIn our single-centre prospective cohort of prevalent (>3-months) haemodialysis recipients, we observed that correlations between frailty tools are modest, and agreement between them upon frailty status was weak. Each of the frailty tools associated with mortality hazard during follow-up. The CFS was the only tool to associate with rates of admission, but equally was the only tool not to associate with length of stay. We identified variable association between frailty tools and ultrasound-derived sarcopenia, and have highlighted that sarcopenia appears to be differentially expressed between males and females receiving haemodialysis. We also identified a novel patient-reported outcome – change in health over the past year – that modulates the association of frailty with mortality, and independently associates with hospitalisation. We propose a notional model of how this may be integrated into frailty assessment for haemodialysis recipients. We have also demonstrated that depression and cognitive impairment are associated with frailty in haemodialysis recipients, and that admissions amongst haemodialysis recipients are highest when cognitive and frailty scores are most discordant. \n \nFrailty is associated with many poor patient outcomes in these analyses, but different frailty tools may be identifying different frailty subtypes. Consensus is required on the optimal frailty tool in haemodialysis recipients to allow comparison and extrapolation of findings across patient cohorts. The Clinical Frailty Scale likely represents the optimal tool in terms of association with negative outcomes and simplicity of use. An evidence-based frailty intervention is urgently required for haemodialysis recipients.
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 | 0,002 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,001 |
| Méta-épidémiologie (sens large) | 0,002 | 0,001 |
| Bibliométrie | 0,004 | 0,002 |
| Études des sciences et des technologies | 0,001 | 0,002 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,002 | 0,000 |
| Intégrité de la recherche | 0,001 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 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 ».