TY - JOUR
T1 - Evaluating the Properties of a Frailty Index and Its Association With Mortality Risk Among Patients With Systemic Lupus Erythematosus
AU - Legge, Alexandra
AU - Kirkland, Susan
AU - Rockwood, Kenneth
AU - Andreou, Pantelis
AU - Bae, Sang Cheol
AU - Gordon, Caroline
AU - Romero-Diaz, Juanita
AU - Sanchez-Guerrero, Jorge
AU - Wallace, Daniel J.
AU - Bernatsky, Sasha
AU - Clarke, Ann E.
AU - Merrill, Joan T
AU - Ginzler, Ellen M.
AU - Fortin, Paul
AU - Gladman, Dafna D.
AU - Urowitz, Murray B.
AU - Bruce, Ian N.
AU - Isenberg, David A
AU - Rahman, Anisur
AU - Alarcón, Graciela S.
AU - Petri, Michelle
AU - Khamashta, Munther A.
AU - Dooley, M. A.
AU - Ramsey-Goldman, Rosalind
AU - Manzi, Susan
AU - Steinsson, Kristjan
AU - Zoma, Asad A.
AU - Aranow, Cynthia
AU - Mackay, Meggan
AU - Ruiz-Irastorza, Guillermo
AU - Lim, S. Sam
AU - Inanc, Murat
AU - van Vollenhoven, Ronald F.
AU - Jonsen, Andreas
AU - Nived, Ola
AU - Ramos-Casals, Manuel
AU - Kamen, Diane L.
AU - Kalunian, Kenneth C
AU - Jacobsen, Soren
AU - Peschken, Christine A.
AU - Askanase, Anca
AU - Hanly, John G.
PY - 2019/8/1
Y1 - 2019/8/1
N2 - 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.
AB - 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.
U2 - 10.1002/art.40859
DO - 10.1002/art.40859
M3 - Article
C2 - 30771242
AN - SCOPUS:85064459503
SN - 2326-5191
VL - 71
SP - 1297
EP - 1307
JO - Arthritis and Rheumatology
JF - Arthritis and Rheumatology
IS - 8
ER -