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.
N1 - Funding Information:
work was supported by the N 阀H (grants 5UL-1TR-001422-02 [formerly UL-1TR-000150], UL-1RR-025741, K24-AR-02318, and P60-AR-064464 [formerly P60-AR-48098]). Dr. Ruiz-阀rastorza’s work was supported by the Department of Education, Universities, and Research of the Basque Government. Dr. Jacobsen’s work was supported by the Danish Rheumatism Association (grant A3865) and the Novo Nordisk Foundation (grant A05990). Dr. Hanly’s work was supported by the Canadian 阀nstitutes of Health Research (grant MOP-88526).
Funding Information:
The Hopkins Lupus Cohort is supported by the N 阀H (grants AR-43727 and AR-69572). The Montreal General Hospital Lupus Clinic is supported in part by the Singer Family Fund for Lupus Research. Dr. Bae’s work was supported in part by the Ministry of Science & 阀CT of the Republic of Korea (grant NRF-2017M3A9B4050335). Dr. Gordon’s work was supported by Lupus UK, the Sandwell and West Birmingham Hospitals NHS Trust, and the N 阀HR/Wellcome Trust Birmingham Clinical Research Facility. Dr. Fortin’s work was supported in part by the Arthritis Society (Distinguished Senior 阀nvestigator Award). Dr. Bruce’s work was supported by the N 阀HR (Senior 阀nvestigator Award), Arthritis Research UK, the N 阀HR Manchester Biomedical Centre, and the N 阀HR/Wellcome Trust Manchester Clinical Research Facility. Drs. 阀senberg and Rahman’s work was supported by the N 阀HR and University College London Hospitals Biomedical Research Center. Dr. Dooley’s work was supported by the N 阀H (grant RR00046). Dr. Ramsey-Goldman’s
Publisher Copyright:
© 2019, American College of Rheumatology
PY - 2019/8
Y1 - 2019/8
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.
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U2 - 10.1002/art.40859
DO - 10.1002/art.40859
M3 - Article
C2 - 30771242
AN - SCOPUS:85064459503
VL - 71
SP - 1297
EP - 1307
JO - Arthritis and Rheumatology
JF - Arthritis and Rheumatology
SN - 2326-5191
IS - 8
ER -