Lisa Cooper1, Ashley Deeb, Aaron R Dezube, Emanuele Mazzola, Clark Dumontier, Angela M Bader, Olga Theou, Michael T Jaklitsch, Laura N Frain. 1. Division of Aging, Brigham and Women's Hospital, Boston, MA Division of Thoracic and Cardiac Surgery, Brigham and Women's Hospital, Boston, MA Department of Data Science, Dana Farber Cancer Institute, Boston, MA New England GRECC (Geriatrics Research, Education and Clinical Center), VA Boston Healthcare System, Boston, Massachusetts, USA Department of Anesthesiology, Brigham and Women's Hospital, Boston, MA Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, MA Physiotherapy, Dalhousie University, Halifax, Nova Scotia, Canada Geriatric Medicine, Dalhousie University, Halifax, Nova Scotia, Canada Geriatric Medicine, Rabin Medical Center, Petach Tikva, Israel.
Abstract
OBJECTIVE: Examine feasibility and construct validity of Pictorial fit frail scale (PFFS) for the first time in older surgical patients. BACKGROUND: The PFFS uses visual images to measure health state in 14 domains and has been previously validated in outpatient geriatric clinics. METHODS: Patients ≥65 year-old who were evaluated in a multidisciplinary thoracic surgery clinic from November 2020 to May 2021 were prospectively included. Patients completed an in-person PFFS and Vulnerable Elders Survey (VES-13) during their visit, and a frailty index was calculated from the PFFS (PFFStrans). A geriatrician performed a comprehensive geriatric assessment (CGA) either in-person or virtually, from which a Frailty Index (FI-CGA) and FRAIL scale were obtained. To assess the validity of the PFFS in this population, the Spearman's rank correlations (rspearman) between PFFStrans and VES-13, FI-CGA, FRAIL were calculated. RESULTS: All 49 patients invited to participate agreed, of which 46/49 (94%) completed the PFFS so a score could be calculated. The majority of patients (59%) underwent an in-person CGA and the reminder (41%) a virtual CGA. The cohort was mainly female (59.0%), with a median age of 77 (range: 67-90). The median PFFStrans was 0.27 (IQR 0.12-0.34), PFFS was 11 (IQR 5-14) and 0.24 (IQR 0.13-0.32) for FI-CGA. We observed a strong correlation between the PFFStrans and FI-CGA (rspearman = 0.81, p < 0.001) and a moderate correlation between PFFStrans and VES-13 and FRAIL score (rspearman 0.68 and 0.64 respectively, p < 0.001). CONCLUSIONS: PFFS had good feasibility and construct validity among older surgical patients when compared to previously validated frailty measurements.
OBJECTIVE: Examine feasibility and construct validity of Pictorial fit frail scale (PFFS) for the first time in older surgical patients. BACKGROUND: The PFFS uses visual images to measure health state in 14 domains and has been previously validated in outpatient geriatric clinics. METHODS: Patients ≥65 year-old who were evaluated in a multidisciplinary thoracic surgery clinic from November 2020 to May 2021 were prospectively included. Patients completed an in-person PFFS and Vulnerable Elders Survey (VES-13) during their visit, and a frailty index was calculated from the PFFS (PFFStrans). A geriatrician performed a comprehensive geriatric assessment (CGA) either in-person or virtually, from which a Frailty Index (FI-CGA) and FRAIL scale were obtained. To assess the validity of the PFFS in this population, the Spearman's rank correlations (rspearman) between PFFStrans and VES-13, FI-CGA, FRAIL were calculated. RESULTS: All 49 patients invited to participate agreed, of which 46/49 (94%) completed the PFFS so a score could be calculated. The majority of patients (59%) underwent an in-person CGA and the reminder (41%) a virtual CGA. The cohort was mainly female (59.0%), with a median age of 77 (range: 67-90). The median PFFStrans was 0.27 (IQR 0.12-0.34), PFFS was 11 (IQR 5-14) and 0.24 (IQR 0.13-0.32) for FI-CGA. We observed a strong correlation between the PFFStrans and FI-CGA (rspearman = 0.81, p < 0.001) and a moderate correlation between PFFStrans and VES-13 and FRAIL score (rspearman 0.68 and 0.64 respectively, p < 0.001). CONCLUSIONS: PFFS had good feasibility and construct validity among older surgical patients when compared to previously validated frailty measurements.
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