title: Frailty index to measure health status in people with systemic sclerosis.
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).
  
  
  CONCLUSIONS
  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.affiliation: 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.
authors.forename: Michael R
authors.initials: MR
authors.lastname: Rockwood
authors.forename: Ellen
authors.initials: E
authors.lastname: MacDonald
authors.forename: Evelyn
authors.initials: E
authors.lastname: Sutton
authors.forename: Kenneth
authors.initials: K
authors.lastname: Rockwood
authors.forename: Murray
authors.initials: M
authors.lastname: Baron
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D002423:Cause of Death; D016208:Databases, Factual; D018450:Disease Progression; D005260:Female; D016330:Frail Elderly / Q000706:statistics & numerical data*; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D009674:Nova Scotia; D011237:Predictive Value of Tests; D015995:Prevalence; D011379:Prognosis; D012372:ROC Curve; D012042:Registries; D018570:Risk Assessment; D012595:Scleroderma, Systemic / Q000175:diagnosis* / Q000401:mortality*; D012720:Severity of Illness Index; D012737:Sex Factors; D015996:Survival Rate
keywords: FRAILTY; FRAILTY INDEX; SCLERODERMA; SYSTEMIC SCLEROSIS