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Development and validation of a frailty index based on data routinely collected across multiple domains in NSW
Sarita Y Lo1, Meggie Zhang1,2, Ruth E Hubbard3
1Laboratory of Ageing and Pharmacology, Faculty of Medicine and Health, Kolling Institute of Medical Research, Royal North Shore Hospital and Northern Clinical School, University of Sydney, Sydney, NSW, Australia.
Objective(S):
To develop and validate a frailty index (FI) that covers multiple domains, using routine hospital data. To investigate the FI's validity, after excluding medication-related items (FI-ExMeds), for studies of frailty and polypharmacy.
Methods:
A FI was derived from routine NSW hospital data following standard published guidance. In a development cohort (151 inpatients ≥ 70 years), the FI was correlated with the Reported Edmonton Frail Scale (REFS) using Pearson's R. Validity and distribution of FI and FI-ExMeds, and correlation with each other, were evaluated in a validation cohort (999 inpatients ≥ 75 years).
Results:
The mean FI for the development cohort was 0.27 (SD 0.09). The FI showed moderate linear correlation with the REFS (n = 148, R = 0.52, P < .001). In the validation cohort, mean FI (n = 993) and FI-ExMeds (n = 990) were both 0.28 (SD 0.11). FI-ExMeds showed high linear correlation with the FI (n = 990, R = 0.99, P < .001).
Conclusion:
This multi-domain FI is comparable to REFS, with adequate redundancy to exclude deficits for specific analyses.
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