Constructing and validating a frailty index as a novel health measure in systemic lupus erythematosus
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For patients with systemic lupus erythematosus (SLE), clinical outcomes are highly variable and challenging to predict. Such differences in susceptibility to adverse health outcomes can be quantified using a frailty index (FI). We used data from an international cohort of recently-diagnosed SLE patients to construct and validate the first FI for patients with SLE, to be known as the SLICC-FI. We assessed whether the SLICC-FI was predictive of future adverse health outcomes including hospitalizations, organ damage and mortality, after adjustment for the SLICC/ACR Damage Index (SDI), a known prognostic factor in SLE. Higher baseline SLICC-FI scores were associated with more hospitalizations, increased organ damage accrual, and increased mortality risk during follow-up. For all three outcomes, the SLICC-FI improved prediction when compared to the SDI alone. The SLICC-FI holds potential value in quantifying vulnerability among patients with SLE and provides additional prognostic information when compared to existing SLE measures.