Arthritis & Rheumatism, Volume 63,
November 2011 Abstract Supplement
Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Chicago, Illinois November 4-9, 2011.
A Patient Reported Frailty Index That Can Predict Mortality Outcomes Among Patients with Arthritis.
Krishnan1, Eswar, Fries2, James F., Lingala3, Bharathi
Physical Frailty, conceptually defined as loss of functional reserves at organ and organism level, is increasingly recognized as a state that is distinct from functional disability and contributes to adverse patient outcomes. There have been few studies that have examined the predictive power of Frailty in patients with arthritis.
Utilizing the domain framework of physical Frailty from published literature, we constructed a simple five-item Patient reported (PRO)-Frailty Index using the following components- fatigue, poor balance, grip strength, anorexia and memory loss. Using Cox regressions, we analyzed the utility of this Index to predict all-cause mortality in a cohort of 3,185 (78% women, mean age 64 years) patients with rheumatoid arthritis and osteoarthritis followed for a mean 4.3 years. Receiver Operating Curve (ROC) analyses were performed to identify the optimal cutoff that can be used to dichotomize the Frailty Index.
The PRO-Frailty Index (range 05) had a near-normal distribution in the population studied with a mean (SD) of 1.3(1.1) overall. The PRO-Frailty Index predicted mortality in age-sex adjusted analyses with a hazard ratio of 1.15 (1.011.31) for each unit increase in PRO-frailty index. In multivariable analyses where the effect of age, gender, disease duration and education level were accounted for, each unit increase in PRO-Frailty Index was associated with 17% increased mortality risk (1.17; 1.021.34). ROC analyses suggested that dichotomizing the index at 0 and >0 offered the best model fit. The frailty-mortality association was observed in both the arthritis categories although the confidence interval was too wide for statistical significance individually.
PRO-Frailty Index can predict mortality among patients with arthritis.
To cite this abstract, please use the following information:
Krishnan, Eswar, Fries, James F., Lingala, Bharathi; A Patient Reported Frailty Index That Can Predict Mortality Outcomes Among Patients with Arthritis. [abstract]. Arthritis Rheum 2011;63 Suppl 10 :910