title: A comparison of Frailty Indexes Based on a Comprehensive Geriatric Assessment for the Prediction of Adverse Outcomes.
abstract: To compare the ability of different frailty indexes based on a standardized comprehensive geriatric assessment (FI-CGAs) for predicting adverse outcomes.
  
  
  
  Prospective cohort study. Geriatric wards of a general hospital.
  
  
  
  307 hospitalized patients ≥ 65 years.
  
  
  
  The FI-CGA-10D (potential health deficits in ten functional domains), the FI-CGA-10D+CM (aforementioned potential health deficits and co-morbidity burden) and the FI-CGA-MIHD (multiple, individual potential health deficits, including functional deficits, co-morbid diseases, amongst others) were assessed at baseline during the patients` hospital stay. The FI-CGAs were analyzed as categorical (according to a FI-CGA score < and ≥ 0.25) and continuous variables. Patients were followed up over 6 months.
  
  
  
  The FI-CGA-10D, FI-CGA-10+CM and the FI-CGA-MIHD predicted 6-month mortality when expressed as categorical (area under the receiver operating characteristic curve (AUC): AUC = 0.611, AUC = 0.637, AUC = 0.616, all p < 0.050, respectively) or continuous variables (AUC = 0.769, AUC = 0.837, AUC = 0.834, all p < 0.001, respectively). AUC comparisons showed that all three FI-CGAs exhibited a comparable ability to predict 6-month mortality when the FI-CGAs were expressed as categorical variables (all p > 0.200) and the FI-CGA-10D+CM and the FI-CGA-MIHD showed a better ability to predict 6-month mortality than the FI-CGA-10D, when the FI-CGAs were expressed as continuous variables (p < 0.001 and p = 0.007, respectively). None of the FI-CGAs predicted any of the other outcomes, i.e., unplanned re-admission to hospital and a fall during follow-up, irrespective of whether the FI-CGAs were expressed as categorical or continuous variables (all p ≥ 0.050).
  
  
  
  The more complex FI-CGAs, i.e., the FI-CGA-10D+CM and the FI-CGA-MIHD, revealed better ability to predict 6 month mortality than the more simple FI-CGA, i.e., the FI-CGA-10D.
authors: Priv.-Doz. Dr. med. Dr. med. univ. Martin Ritt, Department of Internal Medicine III (Medicine of Ageing), Geriatrics Centre Erlangen, Hospital of the Congregation of St. Francis Sisters of Vierzehnheiligen Rathsbergerstraße 57, D-91054 Erlangen, Germany, Tel: +49-(0)9131 822 3702, Fax: +49-(0)9131 822 3703, Email: Martin.Ritt@waldkrankenhaus.de.
authors: M
authors: M
authors: Ritt
authors: K H
authors: KH
authors: Rádi
authors: C
authors: C
authors: Schwarz
authors: L C
authors: LC
authors: Bollheimer
authors: C C
authors: CC
authors: Sieber
authors: K G
authors: KG
authors: Gaßmann
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D016330:Frail Elderly / Q000706:statistics & numerical data*; D015577:Geriatric Assessment / Q000379:methods*; D006801:Humans; D007902:Length of Stay; D008297:Male; D009026:Mortality; D011379:Prognosis; D011446:Prospective Studies; D012372:ROC Curve