Evaluating the Properties of a Frailty Index and Its Association With Mortality Risk Among Patients With Systemic Lupus Erythematosus

Alexandra Legge; Susan Kirkland; Kenneth Rockwood; Pantelis Andreou; Sang-Cheol Bae; Caroline Gordon; Juanita Romero-Diaz; Jorge Sanchez-Guerrero; Daniel J Wallace; Sasha Bernatsky; Ann E Clarke; Joan T Merrill; Ellen M Ginzler; Paul Fortin; Dafna D Gladman; Murray B Urowitz; Ian N Bruce; David A Isenberg; Anisur Rahman; Graciela S Alarcón; Michelle Petri; Munther A Khamashta; M A Dooley; Rosalind Ramsey-Goldman; Susan Manzi; Kristjan Steinsson; Asad A Zoma; Cynthia Aranow; Meggan Mackay; Guillermo Ruiz-Irastorza; S Sam Lim; Murat Inanc; Ronald F van Vollenhoven; Andreas Jonsen; Ola Nived; Manuel Ramos-Casals; Diane L Kamen; Kenneth C Kalunian; Soren Jacobsen; Christine A Peschken; Anca Askanase; John G Hanly

doi:10.1002/art.40859

Evaluating the Properties of a Frailty Index and Its Association With Mortality Risk Among Patients With Systemic Lupus Erythematosus

Alexandra Legge, Susan Kirkland, Kenneth Rockwood, Pantelis Andreou, Sang-Cheol Bae, Caroline Gordon, Juanita Romero-Diaz, Jorge Sanchez-Guerrero, Daniel J Wallace, Sasha Bernatsky, Ann E Clarke, Joan T Merrill, Ellen M Ginzler, Paul Fortin, Dafna D Gladman, Murray B Urowitz, Ian N Bruce, David A Isenberg, Anisur Rahman, Graciela S AlarcónMichelle Petri, Munther A Khamashta, M A Dooley, Rosalind Ramsey-Goldman, Susan Manzi, Kristjan Steinsson, Asad A Zoma, Cynthia Aranow, Meggan Mackay, Guillermo Ruiz-Irastorza, S Sam Lim, Murat Inanc, Ronald F van Vollenhoven, Andreas Jonsen, Ola Nived, Manuel Ramos-Casals, Diane L Kamen, Kenneth C Kalunian, Soren Jacobsen, Christine A Peschken, Anca Askanase, John G Hanly

Afdeling for Rygkirurgi, Led- og Bindevævssygdomme

37 Citationer (Scopus)

Abstract

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.

Originalsprog	Engelsk
Tidsskrift	Arthritis & rheumatology
Vol/bind	71
Udgave nummer	8
Sider (fra-til)	1297-1307
Antal sider	11
ISSN	2326-5191
DOI	https://doi.org/10.1002/art.40859
Status	Udgivet - aug. 2019

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10.1002/art.40859

Citationsformater

Legge, A., Kirkland, S., Rockwood, K., Andreou, P., Bae, S.-C., Gordon, C., Romero-Diaz, J., Sanchez-Guerrero, J., Wallace, D. J., Bernatsky, S., Clarke, A. E., Merrill, J. T., Ginzler, E. M., Fortin, P., Gladman, D. D., Urowitz, M. B., Bruce, I. N., Isenberg, D. A., Rahman, A., ... Hanly, J. G. (2019). Evaluating the Properties of a Frailty Index and Its Association With Mortality Risk Among Patients With Systemic Lupus Erythematosus. Arthritis & rheumatology, 71(8), 1297-1307. https://doi.org/10.1002/art.40859

Legge, A, Kirkland, S, Rockwood, K, Andreou, P, Bae, S-C, Gordon, C, Romero-Diaz, J, Sanchez-Guerrero, J, Wallace, DJ, Bernatsky, S, Clarke, AE, Merrill, JT, Ginzler, EM, Fortin, P, Gladman, DD, Urowitz, MB, Bruce, IN, Isenberg, DA, Rahman, A, Alarcón, GS, Petri, M, Khamashta, MA, Dooley, MA, Ramsey-Goldman, R, Manzi, S, Steinsson, K, Zoma, AA, Aranow, C, Mackay, M, Ruiz-Irastorza, G, Lim, SS, Inanc, M, van Vollenhoven, RF, Jonsen, A, Nived, O, Ramos-Casals, M, Kamen, DL, Kalunian, KC, Jacobsen, S, Peschken, CA, Askanase, A & Hanly, JG 2019, 'Evaluating the Properties of a Frailty Index and Its Association With Mortality Risk Among Patients With Systemic Lupus Erythematosus', Arthritis & rheumatology, bind 71, nr. 8, s. 1297-1307. https://doi.org/10.1002/art.40859

@article{4735b21953824ec5a9cb02e45e41914f,

title = "Evaluating the Properties of a Frailty Index and Its Association With Mortality Risk Among Patients With Systemic Lupus Erythematosus",

abstract = "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.",

author = "Alexandra Legge and Susan Kirkland and Kenneth Rockwood and Pantelis Andreou and Sang-Cheol Bae and Caroline Gordon and Juanita Romero-Diaz and Jorge Sanchez-Guerrero and Wallace, {Daniel J} and Sasha Bernatsky and Clarke, {Ann E} and Merrill, {Joan T} and Ginzler, {Ellen M} and Paul Fortin and Gladman, {Dafna D} and Urowitz, {Murray B} and Bruce, {Ian N} and Isenberg, {David A} and Anisur Rahman and Alarc{\'o}n, {Graciela S} and Michelle Petri and Khamashta, {Munther A} and Dooley, {M A} and Rosalind Ramsey-Goldman and Susan Manzi and Kristjan Steinsson and Zoma, {Asad A} and Cynthia Aranow and Meggan Mackay and Guillermo Ruiz-Irastorza and Lim, {S Sam} and Murat Inanc and {van Vollenhoven}, {Ronald F} and Andreas Jonsen and Ola Nived and Manuel Ramos-Casals and Kamen, {Diane L} and Kalunian, {Kenneth C} and Soren Jacobsen and Peschken, {Christine A} and Anca Askanase and Hanly, {John G}",

note = "{\textcopyright} 2019, American College of Rheumatology.",

year = "2019",

month = aug,

doi = "10.1002/art.40859",

language = "English",

volume = "71",

pages = "1297--1307",

journal = "Arthritis & rheumatology",

issn = "2326-5191",

publisher = "John Wiley and Sons Ltd",

number = "8",

}

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

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.

U2 - 10.1002/art.40859

DO - 10.1002/art.40859

M3 - Journal article

C2 - 30771242

SN - 2326-5191

VL - 71

SP - 1297

EP - 1307

JO - Arthritis & rheumatology

JF - Arthritis & rheumatology

IS - 8

ER -

Evaluating the Properties of a Frailty Index and Its Association With Mortality Risk Among Patients With Systemic Lupus Erythematosus

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