Abstract: FR-PO920

Evaluation of a Patient-Directed Frailty Screening Tool for Use in CKD

Session Information

  • Geriatric Nephrology
    November 03, 2017 | Location: Hall H, Morial Convention Center
    Abstract Time: 10:00 AM - 10:00 AM

Category: Geriatric Nephrology

  • 901 Geriatric Nephrology

Authors

  • Nixon, Andrew, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, United Kingdom
  • Bampouras, Theodoros M, University of Cumbria, Lancaster, United Kingdom
  • Petrie, Alastair Ross, University of Cumbria, Lancaster, United Kingdom
  • Afolabi, Atinuke Janet, University of Cumbria, Lancaster, United Kingdom
  • Pendleton, Neil, University of Manchester, Manchester, United Kingdom
  • Mitra, Sandip, Central Manchester University Hospitals NHS Foundation Trust, Manchester, United Kingdom
  • Dhaygude, Ajay Prabhakar, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, United Kingdom
Background

Frailty is associated with adverse outcomes in Chronic Kidney Disease (CKD). There is a need for a frailty screening tool that is well-validated in CKD. The British Geriatric Society (BGS) has suggested that the PRISMA 7 questionnaire is a useful self-assessment screening method for frailty in the general population. However, it has not yet been validated in those with CKD.

Methods

Fifty-eight dialysis-dependent CKD and pre-dialysis stage 4 and 5 CKD patients were recruited. Patients were asked to complete the PRISMA 7 questionnaire. As suggested by the BGS, a score of ≥3 was considered to identify frailty. Frailty was also assessed using two operationalised frailty definitions: the frailty phenotype (FP) and the frailty index (FI). The correlation between PRISMA 7 scores and FP and FI scores was assessed. ROC curves were calculated to assess the PRISMA 7 questionnaire's sensitivity and specificity.

Results

Median age was 70 years old (IQR: 58.75-77.00) with 28 male patients. Half were receiving haemodialysis. Mean Charlson Comorbidity Index was 3.12 (SD: 1.29). The PRISMA 7 identified 48% as frail. Using the FP, frailty prevalance was 24%. Mean FI was 0.32 (SD: 0.13). The PRISMA 7 scores correlated moderately well with FP (r=0.66, 95% CI 0.52-0.78) and FI (r=0.76, 95% CI 0.66-0.84) scores. Figure 1 demonstrates the ROC curve for the PRISMA 7. The ROC AUC was 0.87 (95% CI 0.77-0.97) for the PRISMA 7. A PRISMA 7 score ≥3 had a sensitivity of 0.93 and specificity of 0.66 for identifying frailty, as defined by the FP.

Conclusion

The PRISMA 7 questionnaire is an effective patient-directed frailty screening tool with excellent sensitivity for identifying frailty. It can be easily incorporated into routine clinical care. Further research is needed to evaluate its prognostic accuracy.

Figure 1. ROC Curve Assessing the PRISMA 7 Questionnaire's Ability to Identify Frailty