Construction of a frailty index as a novel health measure in systemic lupus erythematosus

Caroline Gordon

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Objective. To construct a frailty index (FI) as a measure of vulnerability to adverse outcomes among patients with SLE, using data from the Systemic Lupus International Collaborating Clinics (SLICC) inception cohort.

Methods. The SLICC inception cohort consists of recently diagnosed SLE patients followed annually with clinical and laboratory assessments. For this analysis, the baseline visit was defined as the first study visit at which sufficient information was available for construction of a frailty index. Following a standard procedure, variables from the SLICC database were evaluated as potential health deficits. Selected health deficits were then used to generate a SLICC frailty index (SLICC-FI). The prevalence of frailty in the baseline dataset was evaluated using established cut points for FI values.

Results. The 1683 SLE patients (92.1% of the overall cohort) eligible for inclusion in the baseline dataset were mostly female (89%) with mean (SD) age 35.7 (13.4) years and mean (SD) disease duration 18.8 (15.7) months at baseline. Of 222 variables, 48 met criteria for inclusion in the SLICC-FI. Mean (SD) SLICC-FI was 0.17 (0.08) with a range from 0 to 0.51. At baseline, 27.1% (95% CI 25.0%-29.2%) of patients were classified as frail, based on SLICC-FI values greater than 0.21.

Conclusion. The SLICC inception cohort permits feasible construction of an FI for use in patients with SLE. Even in a relatively young cohort of SLE patients, frailty was common. The SLICC-FI may be a useful tool for identifying SLE patients who are most vulnerable to adverse outcomes but validation of this index is required prior to its use.

Original languageEnglish
Article number181338
JournalThe Journal of Rheumatology
Issue number5
Publication statusPublished - 1 May 2019


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