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Evaluating the Properties of a Frailty Index and Its Association With Mortality Risk Among Patients With Systemic Lupus Erythematosus.

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Authors
Legge, Alexandra
Kirkland, Susan
Rockwood, Kenneth
Andreou, Pantelis
Bae, Sang-Cheol
Gordon, Caroline
Romero-Diaz, Juanita
Sanchez-Guerrero, Jorge
Wallace, Daniel J
Bernatsky, Sasha
Clarke, Ann E
Merrill, Joan T
Ginzler, Ellen M
Fortin, Paul
Gladman, Dafna D
Urowitz, Murray B
Bruce, Ian N
Isenberg, David A
Rahman, Anisur
Alarcón, Graciela S
Petri, Michelle
Khamashta, Munther A
Dooley, M A
Ramsey-Goldman, Rosalind
Manzi, Susan
Steinsson, Kristjan
Zoma, Asad A
Aranow, Cynthia
Mackay, Meggan
Ruiz-Irastorza, Guillermo
Lim, S Sam
Inanc, Murat
van Vollenhoven, Ronald F
Jonsen, Andreas
Nived, Ola
Ramos-Casals, Manuel
Kamen, Diane L
Kalunian, Kenneth C
Jacobsen, Soren
Peschken, Christine A
Askanase, Anca
Hanly, John G
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Issue Date
2019-08

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Citation
Evaluating the Properties of a Frailty Index and Its Association With Mortality Risk Among Patients With Systemic Lupus Erythematosus. 2019, 71(8):1297-1307 Arthritis Rheumatol
Abstract
OBJECTIVE: To evaluate the properties of a frailty index (FI), constructed using data from the Systemic Lupus International Collaborating Clinics (SLICC) inception cohort, as a novel health measure in systemic lupus erythematosus (SLE). METHODS: For this secondary analysis, the baseline visit was defined as the first study visit at which both organ damage (SLICC/American College of Rheumatology Damage Index [SDI]) and health-related quality of life (Short-Form 36 [SF-36] scores) were assessed. The SLICC-FI was constructed using baseline data. The SLICC-FI comprises 48 health deficits, including items related to organ damage, disease activity, comorbidities, and functional status. Content, construct, and criterion validity of the SLICC-FI were assessed. Multivariable Cox regression was used to estimate the association between baseline SLICC-FI values and mortality risk, adjusting for demographic and clinical factors. RESULTS: In the baseline data set of 1,683 patients with SLE, 89% were female, the mean ± SD age was 35.7 ± 13.4 years, and the mean ± SD disease duration was 18.8 ± 15.7 months. At baseline, the mean ± SD SLICC-FI score was 0.17 ± 0.08 (range 0-0.51). Baseline SLICC-FI values exhibited the expected measurement properties and were weakly correlated with baseline SDI scores (r = 0.26, P < 0.0001). Higher baseline SLICC-FI values (per 0.05 increment) were associated with increased mortality risk (hazard ratio 1.59, 95% confidence interval 1.35-1.87), after adjusting for age, sex, steroid use, ethnicity/region, and baseline SDI scores. CONCLUSION: The SLICC-FI demonstrates internal validity as a health measure in SLE and might be used to predict future mortality risk. The SLICC-FI is potentially valuable for quantifying vulnerability among patients with SLE, and adds to existing prognostic scores.
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Additional Links
https://onlinelibrary.wiley.com/doi/full/10.1002/art.40859
ae974a485f413a2113503eed53cd6c53
10.1002/art.40859
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English Journal Articles (Peer Reviewed)

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