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Evaluating the properties of a frailty index and its association with mortality risk among patients with systemic lupus erythematosus

Legge, A; Kirkland, S; Rockwood, K; Andreou, P; Bae, S-C; Gordon, C; Romero-Diaz, J; ... Hanly, JG; + view all (2019) Evaluating the properties of a frailty index and its association with mortality risk among patients with systemic lupus erythematosus. Arthritis and Rheumatology , 71 (8) pp. 1297-1307. 10.1002/art.40859. Green open access

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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 SLE. Methods: For this secondary analysis, the baseline visit was defined as the first study visit at which both organ damage (SLICC/ACR Damage Index [SDI]) and health‐related quality of life (Short‐Form 36 [SF‐36]) 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: The 1683 SLE patients in the baseline dataset were 89% female with mean (SD) age 35.7 (13.4) years and mean (SD) disease duration 18.8 (15.7) months. At baseline, the mean (SD) SLICC‐FI score was 0.17 (0.08) with a range from 0 to 0.51. Baseline SLICC‐FI values exhibited the expected measurement properties and were weakly correlated with baseline SDI scores (r=0.262; p<0.0001). Higher baseline SLICC‐FI values (per 0.05 increment) were associated with increased mortality risk (Hazard Ratio 1.59; 95%CI 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 predicts future mortality risk. The SLICC‐FI is potentially valuable for quantifying vulnerability among patients with SLE, and adds to existing prognostic scores.

Type: Article
Title: Evaluating the properties of a frailty index and its association with mortality risk among patients with systemic lupus erythematosus
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1002/art.40859
Publisher version: https://doi.org/10.1002/art.40859
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Inflammation
URI: https://discovery.ucl.ac.uk/id/eprint/10069277
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