Validation of a Record-based Frailty Assessment According to the Multidimensional Prognostic Index

NCT ID: NCT03794674

Last Updated: 2019-10-08

Basic Information

• Recruitment Status: COMPLETED
• Total Enrollment: 92 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2018-12-04
• Study Completion Date: 2019-02-22

Brief Summary

Background Various phenotype and cumulative frailty assessment tools have been developed and compared in research. For use in an in-hospital setting, a cumulative and graded frailty assessment method is preferred in order to identify subgroups of patients at risk of adverse events during discharge and transition to primary care. Comprehensive Geriatric Assessment (CGA) is the gold standard to assess frailty. Most medical wards have limited access to specialized geriatric team support capable of performing CGA. Thus in these wards there is a need for a CGA based instrument to identify the frail patients and to quantify the level of frailty. The Multidimensional Prognostic Index (MPI) is based on CGA and is a comprehensive cumulative deficit frailty assessment tool validated in a Danish geriatric department. MPI is fully applicable in the everyday clinical work and supplies useful information to clinicians. It can predict readmission and death, and it is well-suited to assess the degree of frailty. Enabling identification of patients at risk of adverse events facilitates targeting of the interventions in order to improve patient outcomes. The MPI is a bedside assessment. However, in observational record-based research the patient is not accessible for the researcher. To assess and identify hospitalized frail patients retrospectively for clinical research, a valid record-based frailty assessment method is needed. The aim of this study is to compare the accuracy of a record-based MPI assessment with a bedside performed MPI assessment in order to use the record-based MPI when access to bedside MPI is impossible.

Conditions

Frail Elderly Syndrome

Study Design

• Observational Model Type: COHORT
• Study Time Perspective: OTHER

Study Groups

MPI test group

50 eligible patients. Frailty level independently assessed by two reviewers based on the medical records and assessed by one research assistant based on bedside testing.

No intervention.

Intervention Type: OTHER

No intervention, since this is a validation study

Interventions

No intervention.

No intervention, since this is a validation study

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• Acutely admitted to one of the two medical departments listed below
• Aged 75 years or older
• Living within the municipality of Aarhus

Exclusion Criteria

• Included in any other kind of follow-up schemes
• Already included in this study
• Declared terminally ill or undergoing palliative care at admission
• Admitted from one specific temporary nursing home with geriatric medical assistance (Vikærgården)
• Discharge or transfer to another department, including hospice
• The patient does not want to participate in the MPI-screening process

• Minimum Eligible Age: 75 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

University of Aarhus

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Troels Hansen, MD

Role: PRINCIPAL_INVESTIGATOR

Aarhus University Hospital and Aarhus University

Locations

Aarhus University

Aarhus, , Denmark

Countries

Denmark

References

Dent E, Kowal P, Hoogendijk EO. Frailty measurement in research and clinical practice: A review. Eur J Intern Med. 2016 Jun;31:3-10. doi: 10.1016/j.ejim.2016.03.007. Epub 2016 Mar 31.

Reference Type: BACKGROUND

PMID: 27039014 (View on PubMed)

Clegg A, Young J, Iliffe S, Rikkert MO, Rockwood K. Frailty in elderly people. Lancet. 2013 Mar 2;381(9868):752-62. doi: 10.1016/S0140-6736(12)62167-9. Epub 2013 Feb 8.

Reference Type: BACKGROUND

PMID: 23395245 (View on PubMed)

Volpato S, Bazzano S, Fontana A, Ferrucci L, Pilotto A; MPI-TriVeneto Study Group. Multidimensional Prognostic Index predicts mortality and length of stay during hospitalization in the older patients: a multicenter prospective study. J Gerontol A Biol Sci Med Sci. 2015 Mar;70(3):325-31. doi: 10.1093/gerona/glu167. Epub 2014 Sep 9.

Reference Type: BACKGROUND

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Reference Type: BACKGROUND

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Gregersen M, Hansen TK, Jørgensen BB, Damsgaard EM. Validation of a modified Multidimensional Prognostic Index obtained at discharge in older Danish geriatric patients to predict acute readmission and mortality. 2018 Unpublished data.

Reference Type: BACKGROUND

Warnier RM, van Rossum E, van Velthuijsen E, Mulder WJ, Schols JM, Kempen GI. Validity, Reliability and Feasibility of Tools to Identify Frail Older Patients in Inpatient Hospital Care: A Systematic Review. J Nutr Health Aging. 2016 Feb;20(2):218-30. doi: 10.1007/s12603-015-0567-z.

Reference Type: BACKGROUND

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Reference Type: BACKGROUND

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de Vet HC, Terwee CB, Knol DL, Bouter LM. When to use agreement versus reliability measures. J Clin Epidemiol. 2006 Oct;59(10):1033-9. doi: 10.1016/j.jclinepi.2005.10.015. Epub 2006 Aug 10.

Reference Type: BACKGROUND

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Reference Type: BACKGROUND

PMID: 17161752 (View on PubMed)

Provided Documents

Document Type: Study Protocol and Statistical Analysis Plan

View Document

Other Identifiers

MPIRECVALID

Identifier Type: -

Identifier Source: org_study_id