Dataset Information

Validation of "(fr)AGILE": a quick tool to identify multidimensional frailty in the elderly.

ABSTRACT: BACKGROUND:Several tools have been proposed and validated to operationally define frailty. Recently, the Italian Frailty index (IFi), an Italian modified version of Frailty index, has been validated but its use in clinical practice is limited by long time of administration. Therefore, the aim of this study was to create and validate a quick version of the IFi (AGILE). METHODS:Validation study was performed by administering IFi and AGILE, after a Comprehensive Geriatric Assessment (CGA) in 401 subjects aged 65 or over (77?±?7?years). AGILE was a 10-items tool created starting from the more predictive items of the four domains of frailty investigated by IFi (mental, physical, socioeconomic and nutritional). AGILE scores were stratified in light, moderate and severe frailty. At 24?months of follow-up, death, disability (taking into account an increase in ADL lost ?1 from the baseline) and hospitalization were considered. Area under curve (AUC) was evaluated for both IFi and AGILE. RESULTS:Administration time was 9.5?±?3.8?min for IFi administered after a CGA, and 2.4?±?1.2?min for AGILE, regardless of CGA (p?

SUBMITTER: Liguori I

PROVIDER: S-EPMC7526099 | biostudies-literature | 2020 Sep

REPOSITORIES: biostudies-literature

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Validation of "(fr)AGILE": a quick tool to identify multidimensional frailty in the elderly.

Liguori Ilaria I Russo Gennaro G Bulli Giulia G Curcio Francesco F Flocco Veronica V Galizia Gianlugi G Della-Morte David D Gargiulo Gaetano G Testa Gianluca G Cacciatore Francesco F Bonaduce Domenico D Abete Pasquale P

BMC geriatrics 20200929 1

<h4>Background</h4>Several tools have been proposed and validated to operationally define frailty. Recently, the Italian Frailty index (IFi), an Italian modified version of Frailty index, has been validated but its use in clinical practice is limited by long time of administration. Therefore, the aim of this study was to create and validate a quick version of the IFi (AGILE).<h4>Methods</h4>Validation study was performed by administering IFi and AGILE, after a Comprehensive Geriatric Assessment ...[more]

PMID: 32993569

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Project description:INTRODUCTION:An increasing number of investigations highlight the complex nature of frailty; therefore, the use of multidimensional assessment instruments could be useful in clinical decision-making. Frail people are found mainly in the community setting which is why this is the ideal environment for early screening and intervention. For this purpose, it is necessary to have valid, time-effective and easy-to-use frailty assessment instruments. The aim of this review is to critically appraise, compare and summarise the quality of the measurement properties of all multidimensional instruments with an integral approach to identify frailty in community-dwelling people. METHODS AND ANALYSIS:Medline, Psychological Information Database (PsycINFO) and Cumulative Index to Nursing and Allied Health Literature (CINAHL) will be searched from their inception dates. We will also conduct searches in databases of grey literature. No limits will be applied for language. A highly sensitive validated search filter will be used for finding studies on measurement properties. An additional search including the names of the instruments found in the initial search will also be undertaken. Studies aiming at the development of a measurement instrument, the evaluation of one or more measurement properties or the evaluation of its interpretability will be included. The instrument should have an integral approach (physical, psychological and social) and it should measure all three domains. The context of use should be a community setting. Two reviewers independently will screen the references and assess the risk of bias by consensus-based standards for the selection of health measurement instruments checklist. To assess the overall evidence for the measurement properties of the identified instruments, the results of the different studies, adjusted for their methodological quality, will be combined. ETHICS AND DISSEMINATION:Ethical approval and patient consent are not required as this is a psychometric review based on published studies. The results of this review will be disseminated at conferences and published in an international peer-reviewed journal. PROSPERO REGISTRATION NUMBER:CRD42019120212.

Project description:STUDY OBJECTIVE:The goal of this study is to create a predictive, interpretable model of early hospital respiratory failure among emergency department (ED) patients admitted with coronavirus disease 2019 (COVID-19). METHODS:This was an observational, retrospective, cohort study from a 9-ED health system of admitted adult patients with severe acute respiratory syndrome coronavirus 2 (COVID-19) and an oxygen requirement less than or equal to 6 L/min. We sought to predict respiratory failure within 24 hours of admission as defined by oxygen requirement of greater than 10 L/min by low-flow device, high-flow device, noninvasive or invasive ventilation, or death. Predictive models were compared with the Elixhauser Comorbidity Index, quick Sequential [Sepsis-related] Organ Failure Assessment, and the CURB-65 pneumonia severity score. RESULTS:During the study period, from March 1 to April 27, 2020, 1,792 patients were admitted with COVID-19, 620 (35%) of whom had respiratory failure in the ED. Of the remaining 1,172 admitted patients, 144 (12.3%) met the composite endpoint within the first 24 hours of hospitalization. On the independent test cohort, both a novel bedside scoring system, the quick COVID-19 Severity Index (area under receiver operating characteristic curve mean 0.81 [95% confidence interval {CI} 0.73 to 0.89]), and a machine-learning model, the COVID-19 Severity Index (mean 0.76 [95% CI 0.65 to 0.86]), outperformed the Elixhauser mortality index (mean 0.61 [95% CI 0.51 to 0.70]), CURB-65 (0.50 [95% CI 0.40 to 0.60]), and quick Sequential [Sepsis-related] Organ Failure Assessment (0.59 [95% CI 0.50 to 0.68]). A low quick COVID-19 Severity Index score was associated with a less than 5% risk of respiratory decompensation in the validation cohort. CONCLUSION:A significant proportion of admitted COVID-19 patients progress to respiratory failure within 24 hours of admission. These events are accurately predicted with bedside respiratory examination findings within a simple scoring system.

Dataset Information

Validation of "(fr)AGILE": a quick tool to identify multidimensional frailty in the elderly.

Publications

Validation of "(fr)AGILE": a quick tool to identify multidimensional frailty in the elderly.

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