Michael R Rockwood1, Ellen MacDonald, Evelyn Sutton, Kenneth Rockwood, Murray Baron. 1. From Geriatric Medicine Research; Division of Rheumatology; Division of Geriatric Medicine, Department of Medicine, Dalhousie University and Capital District Health Authority, Halifax, Nova Scotia; and Division of Rheumatology, Department of Medicine, McGill University and SMBD-Jewish General Hospital, Montreal, Quebec, Canada.
Abstract
OBJECTIVE: To develop and validate, as a measure of overall health status, a Frailty Index (FI) for patients (n=1372) in the Canadian Scleroderma Research Group (CSRG) Registry. METHODS: Forty-four items were selected from the CSRG database as health deficits and recoded using FI criteria. To test construct validity, we compared measurement properties of the CSRG-FI to other FI, and related it to measures of damage, age, and time since diagnosis. To test criterion validity, we compared the baseline FI to that at last recorded visit and to mortality. RESULTS: The mean CSRG-FI was 0.33 with a sub-maximal limit of 0.67. In patients with diffuse disease, the mean was 0.38(SD 0.14); in patients with limited disease, the mean was 0.31(SD 0.13). The CSRG-FI was weakly (but significantly) correlated with the Rodnan Skin Score (r=0.28 in people with diffuse disease; 0.18 with limited) and moderately with the Physician Assessment of Damage (r=0.51 for both limited and diffuse). The risk of death increased with higher FI scores and with higher physician ratings of damage. The area under the receiver operating characteristic curve for the baseline FI in relation to death was 0.75, higher than for other measures (range: 0.57-0.67). CONCLUSION: The FI quantifies overall health status in people with scleroderma and predicts mortality. Whether the FI might help with decisions about who might best be served by more aggressive treatment, such as bone marrow transplantation, needs to be evaluated.
OBJECTIVE: To develop and validate, as a measure of overall health status, a Frailty Index (FI) for patients (n=1372) in the Canadian Scleroderma Research Group (CSRG) Registry. METHODS: Forty-four items were selected from the CSRG database as health deficits and recoded using FI criteria. To test construct validity, we compared measurement properties of the CSRG-FI to other FI, and related it to measures of damage, age, and time since diagnosis. To test criterion validity, we compared the baseline FI to that at last recorded visit and to mortality. RESULTS: The mean CSRG-FI was 0.33 with a sub-maximal limit of 0.67. In patients with diffuse disease, the mean was 0.38(SD 0.14); in patients with limited disease, the mean was 0.31(SD 0.13). The CSRG-FI was weakly (but significantly) correlated with the Rodnan Skin Score (r=0.28 in people with diffuse disease; 0.18 with limited) and moderately with the Physician Assessment of Damage (r=0.51 for both limited and diffuse). The risk of death increased with higher FI scores and with higher physician ratings of damage. The area under the receiver operating characteristic curve for the baseline FI in relation to death was 0.75, higher than for other measures (range: 0.57-0.67). CONCLUSION: The FI quantifies overall health status in people with scleroderma and predicts mortality. Whether the FI might help with decisions about who might best be served by more aggressive treatment, such as bone marrow transplantation, needs to be evaluated.
Authors: Alexandra Legge; Susan Kirkland; Kenneth Rockwood; Pantelis Andreou; Sang-Cheol Bae; Caroline Gordon; Juanita Romero-Diaz; Jorge Sanchez-Guerrero; Daniel J Wallace; Sasha Bernatsky; Ann E Clarke; Joan T Merrill; Ellen M Ginzler; Paul Fortin; Dafna D Gladman; Murray B Urowitz; Ian N Bruce; David A Isenberg; Anisur Rahman; Graciela S Alarcón; Michelle Petri; Munther A Khamashta; M A Dooley; Rosalind Ramsey-Goldman; Susan Manzi; Kristjan Steinsson; Asad A Zoma; Cynthia Aranow; Meggan Mackay; Guillermo Ruiz-Irastorza; S Sam Lim; Murat Inanc; Ronald F van Vollenhoven; Andreas Jonsen; Ola Nived; Manuel Ramos-Casals; Diane L Kamen; Kenneth C Kalunian; Soren Jacobsen; Christine A Peschken; Anca Askanase; John G Hanly Journal: Arthritis Rheumatol Date: 2019-05-29 Impact factor: 10.995
Authors: Alexandra Legge; Susan Kirkland; Kenneth Rockwood; Pantelis Andreou; Sang-Cheol Bae; Caroline Gordon; Juanita Romero-Diaz; Jorge Sanchez-Guerrero; Daniel J Wallace; Sasha Bernatsky; Ann E Clarke; Joan T Merrill; Ellen M Ginzler; Paul Fortin; Dafna D Gladman; Murray B Urowitz; Ian N Bruce; David A Isenberg; Anisur Rahman; Graciela S Alarcón; Michelle Petri; Munther A Khamashta; M A Dooley; Rosalind Ramsey-Goldman; Susan Manzi; Asad A Zoma; Cynthia Aranow; Meggan Mackay; Guillermo Ruiz-Irastorza; S Sam Lim; Murat Inanc; Ronald F van Vollenhoven; Andreas Jonsen; Ola Nived; Manuel Ramos-Casals; Diane L Kamen; Kenneth C Kalunian; Soren Jacobsen; Christine A Peschken; Anca Askanase; John G Hanly Journal: J Rheumatol Date: 2019-04-15 Impact factor: 4.666
Authors: Joanna M Blodgett; Mario U Pérez-Zepeda; Judith Godin; D Scott Kehler; Melissa K Andrew; Susan Kirkland; Kenneth Rockwood; Olga Theou Journal: Age Ageing Date: 2022-05-01 Impact factor: 12.782
Authors: Alexandra Legge; Susan Kirkland; Kenneth Rockwood; Pantelis Andreou; Sang-Cheol Bae; Caroline Gordon; Juanita Romero-Diaz; Jorge Sanchez-Guerrero; Daniel J Wallace; Sasha Bernatsky; Ann E Clarke; Joan T Merrill; Ellen M Ginzler; Paul R Fortin; Dafna D Gladman; Murray B Urowitz; Ian N Bruce; David A Isenberg; Anisur Rahman; Graciela S Alarcón; Michelle Petri; Munther A Khamashta; M A Dooley; Rosalind Ramsey-Goldman; Susan Manzi; Asad A Zoma; Cynthia Aranow; Meggan Mackay; Guillermo Ruiz-Irastorza; S Sam Lim; Murat Inanc; Ronald F van Vollenhoven; Andreas Jonsen; Ola Nived; Manuel Ramos-Casals; Diane L Kamen; Kenneth C Kalunian; Soren Jacobsen; Christine A Peschken; Anca Askanase; John G Hanly Journal: Arthritis Rheumatol Date: 2020-02-12 Impact factor: 15.483
Authors: Alexandra Legge; Susan Kirkland; Kenneth Rockwood; Pantelis Andreou; Sang-Cheol Bae; Caroline Gordon; Juanita Romero-Diaz; Jorge Sanchez-Guerrero; Daniel J Wallace; Sasha Bernatsky; Ann E Clarke; Joan T Merrill; Ellen M Ginzler; Paul R Fortin; Dafna D Gladman; Murray B Urowitz; Ian N Bruce; David A Isenberg; Anisur Rahman; Graciela S Alarcón; Michelle Petri; Munther A Khamashta; M A Dooley; Rosalind Ramsey-Goldman; Susan Manzi; Asad A Zoma; Cynthia Aranow; Meggan Mackay; Guillermo Ruiz-Irastorza; S Sam Lim; Murat Inanc; Ronald F van Vollenhoven; Andreas Jonsen; Ola Nived; Manuel Ramos-Casals; Diane L Kamen; Kenneth C Kalunian; Søren Jacobsen; Christine A Peschken; Anca Askanase; John G Hanly Journal: Arthritis Care Res (Hoboken) Date: 2022-02-17 Impact factor: 5.178