학술논문

A clinical frailty scale obtained from MDT discussion performs poorly in assessing frailty in haemodialysis recipients
Document Type
article
Source
BMC Nephrology, Vol 24, Iss 1, Pp 1-15 (2023)
Subject
Frailty
Haemodialysis
Mortality
Hospitalisation
Clinical Frailty Scale
Diseases of the genitourinary system. Urology
RC870-923
Language
English
ISSN
1471-2369
Abstract
Abstract Background The Clinical Frailty Scale (CFS) is a commonly utilised frailty screening tool that has been associated with hospitalisation and mortality in haemodialysis recipients, but is subject to heterogenous methodologies including subjective clinician opinion. The aims of this study were to (i) examine the accuracy of a subjective, multidisciplinary assessment of CFS at haemodialysis Quality Assurance (QA) meetings (CFS-MDT), compared with a standard CFS score via clinical interview, and (ii) ascertain the associations of these scores with hospitalisation and mortality. Methods We performed a prospective cohort study of prevalent haemodialysis recipients linked to national datasets for outcomes including mortality and hospitalisation. Frailty was assessed using the CFS after structured clinical interview. The CFS-MDT was derived from consensus at haemodialysis QA meetings, involving dialysis nurses, dietitians, and nephrologists. Results 453 participants were followed-up for a median of 685 days (IQR 544–812), during which there were 96 (21.2%) deaths and 1136 hospitalisations shared between 327 (72.1%) participants. Frailty was identified in 246 (54.3%) participants via CFS, but only 120 (26.5%) via CFS-MDT. There was weak correlation (Spearman Rho 0.485, P