Evaluating frailty scores to predict mortality in older adults using data from population based electronic health records: Case control study

Stow, Daniel; Matthews, Fiona E.; Barclay, Stephen; Iliffe, Steve; Clegg, Andrew; De Biase, Sarah; Robinson, Louise; Hanratty, Barbara

Abstract

Background: recognising that a patient is nearing the end of life is essential, to enable professional carers to discuss prognosis and preferences for end of life care. Objective: investigate whether an electronic frailty index (eFI) generated from routinely collected data, can be used to predict mortality at an individual level. Design: historical prospective case control study. Setting: UK primary care electronic health records. Subjects: 13,149 individuals age 75 and over who died between 01/01/2015 and 01/01/2016, 1:1 matched by age and sex to individuals with no record of death in the same time period. Methods: two subsamples were randomly selected to enable development and validation of the association between eFI 3 months prior to death and mortality. Receiver operator characteristic (ROC) analyses were used to examine diagnostic accuracy of eFI at 3 months prior to death. Results: an eFI > 0.19 predicted mortality in the development sample at 75% sensitivity and 69% area under received operating curve (AUC). In the validation dataset this cut point gave 76% sensitivity, 53% specificity. Conclusions: the eFI measured at a single time point has low predictive value for individual risk of death, even 3 months prior to death. Although the eFI is a strong predictor or mortality at a population level, its use for individuals is far less clear.

Citation

Stow, D., Matthews, F. E., Barclay, S., Iliffe, S., Clegg, A., De Biase, S., Robinson, L., & Hanratty, B. (2018). Evaluating frailty scores to predict mortality in older adults using data from population based electronic health records: Case control study. Age and ageing, 47(4), 564-569. https://doi.org/10.1093/ageing/afy022

• Journal Article Type: Article
• Publication Date: Jul 1, 2018
• Deposit Date: Dec 8, 2023
• Journal: Age and Ageing
• Print ISSN: 0002-0729
• Electronic ISSN: 1468-2834
• Publisher: Oxford University Press
• Volume: 47
• Issue: 4
• Pages: 564-569
• DOI: https://doi.org/10.1093/ageing/afy022
• Public URL: https://hull-repository.worktribe.com/output/4452665