It is YOUR DOCTOR'S RESPONSIBILITY to get you out of the lower scores in this post stroke. YOUR DOCTOR'S RESPONSIBILITY!
CSHA Clinical Frailty Scale
Kenneth Rockwood, Xiaowei Song, Chris MacKnight, Howard Bergman, David B. Hogan,Ian McDowell, Arnold Mitnitski
Abstract
Background:There is no single generally accepted clinical definition of frailty. Previously developed tools to assess frailty that
have been shown to be predictive of death or need for entry
into an institutional facility have not gained acceptance
among practising clinicians. We aimed to develop a tool that
would be both predictive and easy to use.
Methods:
We developed the 7-point Clinical Frailty Scale and applied it and other established tools that measure frailty to 2305
elderly patients who participated in the second stage of the
Canadian Study of Health and Aging (CSHA). We followed
this cohort prospectively; after 5 years, we determined the
ability of the Clinical Frailty Scale to predict death or need for
institutional care, and correlated the results with those obtained from other established tools.
Results: The CSHA Clinical Frailty Scale was highly correlated
(r = 0.80) with the Frailty Index. Each 1-category increment of
our scale significantly increased the medium-term risks of
death (21.2% within about 70 mo, 95% confidence interval
[CI] 12.5%–30.6%) and entry into an institution (23.9%, 95%
CI 8.8%–41.2%) in multivariable models that adjusted for age,
sex and education. Analyses of receiver operating characteristic curves showed that our Clinical Frailty Scale performed
better than measures of cognition, function or comorbidity in
assessing risk for death (area under the curve 0.77 for 18-
month and 0.70 for 70-month mortality).
Interpretation:
Frailty is a valid and clinically important construct
that is recognizable by physicians. Clinical judgments about
frailty can yield useful predictive information.
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