Índice frágil-VIG: Validez convergente y discriminativa respecto a la Short Physical Performance Battery en población general / Frail-VIG index: Convergent and discriminatory validity with respect to Short Physical Performance Battery in general population

Antecedentes y objetivo: El estudio de la fragilidad en atención primaria (AP) mediante índices de fragilidad (IF) es escaso. El índice frágil-VIG evalúa el grado de fragilidad con un enfoque multidimensional. El objetivo principal fue investigar la validez convergente y discriminativa del índice frágil-VIG respecto a la Short Physical Performance Battery (SPPB) en población general ≥ 70 años. Población, materiales y métodos: Estudio descriptivo transversal. Se incluyeron 416 participantes no institucionalizados ≥ 70 años de dos cupos de un centro de salud semiurbano. Las variables principales fueron el índice frágil-VIG y la SPPB. Resultados: El valor bajo la curva ROC del índice frágil-VIG respecto a la SPPB < 7 fue de 0,81 (IC 95% 0,76-0,86). La correlación fue -0,59 (IC 95% -0,524 a -0,649). La media del índice frágil-VIG en los participantes clasificados como no frágiles por SPPB < 7 fue 0,103 (IC 95% 0,094-0,112) y en los clasificados como frágiles, 0,242 (IC 95% 0,215-0,269). Se obtuvieron diferencias significativas en la media y distribución de la SPPB, según las categorías del índice frágil-VIG. La prevalencia de fragilidad según el índice frágil-VIG fue de 29,3% (IC 95% 25,2-33,9), inicial 19%, intermedia 7,5%, avanzada 2,9%. Se clasificaron como participantes frágiles según el índice frágil-VIG y no según la SPPB < 7, 10,4%, y al contrario 9,6%, siendo la media de dominios del índice frágil-VIG afectados 3,9 y 2,2, respectivamente. Conclusiones: El índice frágil-VIG presenta una adecuada validez convergente y discriminativa respecto a la SPPB, lo cual avala su uso en AP. Hay un 20% de participantes clasificados como frágiles de manera discordante, con distinto perfil. (AU)

Background and objective: Studies of frailty in primary health care (PHC) using frailty indexes are scarce. Frail-VIG index assesses the level of frailty through a multidimensional approach. The main objective was to investigate the convergent and discriminative validity of the frail-VIG index with respect to Short Physical Performance Battery (SPPB) in general population ≥ 70 years. Population, materials and methods: Descriptive cross-sectional study. We included 416 non-institutionalized patients aged 70 years or over from two lists of general practitioners in a semi-urban healthcare center. Main variables were: frail-VIG index and SPPB. Results: The value of the area under the ROC curve of frail-VIG index respect SPPB < 7 was 0.81 (95% CI: 0.76–0.86). Pearson's correlation coefficient was −0.59 (95% CI: −0.524 to −0.649). The mean of frail-VIG index in those classified as not frail by SPPB < 7 was 0.103 (95% CI: 0.094–0.112) and in the frail was 0.242 (95% CI: 0.215–0.269). We obtained significant differences in the mean and distribution of the SPPB according to the frail-VIG index categories. The frailty prevalence according to the frail-VIG index was 29.3% (95% CI: 25.2–33.9), initial 19%, intermediate 7.5% and advanced 2.9%. There were frailty people by frail-VIG index and not by SPPB < 7 the 10.4%; on the contrary the 9.6%, the mean of affected domains of frail-VIG index was 3.9 and 2.2, respectively. Conclusions: The frail-VIG index presents adequate convergent and discriminative validity with respect to the SPPB that supports the use in PHC. There is a 20% of participants classified as frail in a discordant way, who presents a different profile. (AU)

[Frail-VIG index: Convergent and discriminatory validity with respect to Short Physical Performance Battery in general population]. / Índice frágil-VIG: Validez convergente y discriminativa respecto a la Short Physical Performance Battery en población general.

BACKGROUND AND OBJECTIVE: Studies of frailty in primary health care (PHC) using frailty indexes are scarce. Frail-VIG index assesses the level of frailty through a multidimensional approach. The main objective was to investigate the convergent and discriminative validity of the frail-VIG index with respect to Short Physical Performance Battery (SPPB) in general population ≥ 70 years. POPULATION, MATERIALS AND METHODS: Descriptive cross-sectional study. We included 416 non-institutionalized patients aged 70 years or over from two lists of general practitioners in a semi-urban healthcare center. Main variables were: frail-VIG index and SPPB. RESULTS: The value of the area under the ROC curve of frail-VIG index respect SPPB < 7 was 0.81 (95% CI: 0.76-0.86). Pearson's correlation coefficient was -0.59 (95% CI: -0.524 to -0.649). The mean of frail-VIG index in those classified as not frail by SPPB < 7 was 0.103 (95% CI: 0.094-0.112) and in the frail was 0.242 (95% CI: 0.215-0.269). We obtained significant differences in the mean and distribution of the SPPB according to the frail-VIG index categories. The frailty prevalence according to the frail-VIG index was 29.3% (95% CI: 25.2-33.9), initial 19%, intermediate 7.5% and advanced 2.9%. There were frailty people by frail-VIG index and not by SPPB < 7 the 10.4%; on the contrary the 9.6%, the mean of affected domains of frail-VIG index was 3.9 and 2.2, respectively. CONCLUSIONS: The frail-VIG index presents adequate convergent and discriminative validity with respect to the SPPB that supports the use in PHC. There is a 20% of participants classified as frail in a discordant way, who presents a different profile.

[Cardiovascular risk of SCORE compared to Framingham. Consequences of the change proposed by the European Societies]. / Riesgo cardiovascular del SCORE comparado con el de Framingham. Consecuencias del cambio propuesto por las Sociedades Europeas.

BACKGROUND AND OBJECTIVE: The European Societies in their last update introduce substantial changes to calculate the cardiovascular risk without thinking about the practical consequences. The objective was to evaluate the agreement between the charts of cardiovascular risk of second and the third recommendations of the European Societies to classify the patients of high risk and to analyze its differences. PATIENTS AND METHOD: Patients (1,227) belonging to 3 primary care centres. Risk calculated to the 10 years by means of the equation of Framingham and SCORE for countries lowers risk. A risk of Framingham > or = 20% or SCORE > or = 5% defined the high risk. RESULTS: The patients of high risk were 8.4% according to Framingham and 5.5% according to SCORE and the coefficient Kappa 0.718. 41.7% of the patients of high risk disagreed: high risk Framingham and SCORE not (40 patients, 88.9%) and high SCORE and Framingham not (5 patients, 11.1%). The group high risk Framingham and SCORE not 1 is constituted by 95% of males, age 60 years, cholesterol 246.2 mg/dl and 37.5% smokers. CONCLUSIONS: The chart SCORE and Framingham have an acceptable agreement, but classify from high risk different percentage of population and with different characteristics. The use of the chart of the SCORE would exclude an important group of patients with Framingham high risk.