Developing an Electronic Frailty Index (eFI) and a biological age trajectory with a cohort of over one million older adults in Hong Kong.

IF 3.3 Q2 GERIATRICS & GERONTOLOGY
Journal of Frailty & Aging Pub Date : 2025-04-01 Epub Date: 2025-03-07 DOI:10.1016/j.tjfa.2025.100021
Tung Wai Auyeung, Carolyn Poey Lyn Kng, Tak Yeung Chan, Elsie Hui, Chi Shing Leung, James Ka Hay Luk, Kwok Yiu Sha, Teresa Kim Kum Yu
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引用次数: 0

Abstract

Background: Electronic health record (EHR) has been in place in many parts of the world. This fits in very well to the frailty index calculation proposed by Rockwood and thus a frailty index can potentially be generated automatically from an EHR database. Therefore, the Hong Kong Hospital Authority (HA) attempted to develop an electronic frailty index (HK eFI), by employing thirty-eight health variables from her own EHR database.

Methods: Five cohorts of patients aged 60 years or above ever attended any services provided by the Hong Kong HA in the year 2015, 2016, 2017, 2018 and 2019, were included. The HK eFI trajectory with ageing, generated by the five cohorts, were compared to the one described by Rockwood's group. Following the UK eFI method, 4 levels of frailty were categorized, and they were examined whether they were related to mortality, readmission rate and hospitalization patient days.

Results: Each successive cohort consisted of increasing number of patients aged 60 years or above. (2015, 1.14 million; 2016, 1.19 million; 2017,1.25 million; 2018, 1.31 million; 2019, 1.38 million). The gradients of the five trajectories ranged from 0.035 to 0.037, representing an increase in FI approximately 3.6 % annually. The intercept of the curves converged at 0.1, representing the FI at age 60 years was 0.1. Compared to the fit group, the adjusted hazard ratios of mortality of the mild, moderate and severe frail group were 1.77, 3.31 and 6.65 respectively and they were all statistically higher than the fit group. (p < 0.005) Likewise, there was a stepwise increase in readmission rate and hospital patient days utilization with increasing frailty levels.

Conclusion: It is feasible to develop an eFI and a biological age trajectory from a large EHR database with local adaptation.

以香港超过一百万名长者为研究对象,制订电子机能衰竭指数及生物年龄轨迹。
背景:电子健康记录(EHR)已在世界许多地方实施。这与Rockwood提出的脆弱性指数计算非常吻合,因此可以从电子病历数据库自动生成脆弱性指数。因此,香港医院管理局(医管局)利用其电子健康档案资料库中的38个健康变量,尝试建立电子虚弱指数(HK eFI)。方法:纳入2015年、2016年、2017年、2018年和2019年曾在香港医管局提供服务的60岁或以上患者的5组队列。研究人员将这5个研究小组得出的随年龄增长的HK eFI轨迹与Rockwood小组描述的轨迹进行了比较。根据英国eFI方法,将虚弱程度分为4个等级,并检查它们是否与死亡率、再入院率和住院天数相关。结果:每个连续队列中,年龄在60岁或以上的患者数量不断增加。(2015年,114万;2016年,119万;2017年,125万年;2018年,131万;2019年,138万)。这5条轨迹的梯度范围为0.035 ~ 0.037,表明FI的年增长率约为3.6%。曲线的截距在0.1处收敛,表示60岁时的FI为0.1。与fit组比较,轻、中、重度体弱组调整后的死亡率危险比分别为1.77、3.31、6.65,均高于fit组,差异有统计学意义。(p < 0.005)同样,随着虚弱程度的增加,再入院率和住院天数利用率也逐步增加。结论:从大型EHR数据库中建立eFI和具有局部适应性的生物年龄轨迹是可行的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Frailty & Aging
Journal of Frailty & Aging GERIATRICS & GERONTOLOGY-
CiteScore
5.90
自引率
7.70%
发文量
54
期刊介绍: The Journal of Frailty & Aging is a peer-reviewed international journal aimed at presenting articles that are related to research in the area of aging and age-related (sub)clinical conditions. In particular, the journal publishes high-quality papers describing and discussing social, biological, and clinical features underlying the onset and development of frailty in older persons.          The Journal of Frailty & Aging is composed by five different sections: - Biology of frailty and aging In this section, the journal presents reports from preclinical studies and experiences focused at identifying, describing, and understanding the subclinical pathophysiological mechanisms at the basis of frailty and aging. - Physical frailty and age-related body composition modifications Studies exploring the physical and functional components of frailty are contained in this section. Moreover, since body composition plays a major role in determining physical frailty and, at the same time, represents the most evident feature of the aging process, special attention is given to studies focused on sarcopenia and obesity at older age. - Neurosciences of frailty and aging The section presents results from studies exploring the cognitive and neurological aspects of frailty and age-related conditions. In particular, papers on neurodegenerative conditions of advanced age are welcomed. - Frailty and aging in clinical practice and public health This journal’s section is devoted at presenting studies on clinical issues of frailty and age-related conditions. This multidisciplinary section particularly welcomes reports from clinicians coming from different backgrounds and specialties dealing with the heterogeneous clinical manifestations of advanced age. Moreover, this part of the journal also contains reports on frailty- and age-related social and public health issues. - Clinical trials and therapeutics This final section contains all the manuscripts presenting data on (pharmacological and non-pharmacological) interventions aimed at preventing, delaying, or treating frailty and age-related conditions.The Journal of Frailty & Aging is a quarterly publication of original papers, review articles, case reports, controversies, letters to the Editor, and book reviews. Manuscripts will be evaluated by the editorial staff and, if suitable, by expert reviewers assigned by the editors. The journal particularly welcomes papers by researchers from different backgrounds and specialities who may want to share their views and experiences on the common themes of frailty and aging.The abstracting and indexing of the Journal of Frailty & Aging is covered by MEDLINE (approval by the National Library of Medicine in February 2016).
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