Legge et al reported the SLICC-Frailty Index (SLICC-FI) for evaluating a patient with SLE for frailty. It consists of a listing of comorbid conditions, disability measures and two laboratory measures. The authors are from multiple institutions in the United States, Canada and Europe.
Patient selection: systemic lupus erythematosus (SLE)
Clinical conditions (scored 0 if absent or 1 if present):
(1) diabetes
(2) malignancy
(3) coronary artery disease
(4) congestive heart failure
(5) peripheral vascular disease
(6) cerebrovascular disease
(7) deforming or erosive arthritis
(8) venous thromboembolism
(9) pulmonary disease
(10) gastrointestinal disease
(11) osteoporosis or avascular necrosis
(12) ocular manifestations related to SLE
(13) SLE myocarditis and/or endocarditis
(14) cognitive impairment
(15) seizures
(16) altered mental status
(17) neuropathy
(18) other neuropsychiatric manifestations
(19) active nephritis
(20) active nephrotic syndrome
(21) active serositis
(22) active inflammatory arthritis
(23) active inflammatory rash
(24) active mucosal ulcers
(25) active vasculitis
(26) hematologic disorder
(27) immunologic disorder
(28) Sjogren's syndrome
(29) hypothyroidism
(30) hypertension
(31) mood disorder
(32) anxiety disorder
(33) headache disorder
Categorical conditions:
(34) body mass index
(35) chronic kidney disease
(36) alopecia
(37) complement level and antibody to double-stranded DNA (ds-DNA)
(38) self-rated health
(39) self-reported deterioration in health
(40) vigorous activities
(41) moderate activities
(42) lifting or carrying groceries
(43) climbing stairs
(44) bending, kneeling or stooping
(45) walking 100 meters
(46) bathing or dressing
(47) self-rated fatigue
(48) self-rated pain
|
Parameter |
Finding |
Points |
|
BMI |
< 18.5 kg per sq m |
1 |
|
|
18.5 to 24.9 |
0 |
|
|
25 to 29.9 |
0.5 |
|
|
>= 30 kg per sq m |
1 |
|
chronic kidney disease |
none |
0 |
|
|
Stage 1 |
0.2 |
|
|
Stage 2 |
0.4 |
|
|
Stage 3 |
0.6 |
|
|
Stage 4 |
0.8 |
|
|
Stage 5 |
1 |
|
alopecia |
no |
0 |
|
|
acute |
0.5 |
|
|
chronic |
1 |
|
complement level/dsDNA |
normal to high |
0 |
|
|
low and negative ds-DNA |
0.5 |
|
|
low and positive ds-DNA |
1 |
|
self-rated health |
excellent |
0 |
|
|
very good |
0.25 |
|
|
good |
0.5 |
|
|
fair |
0.75 |
|
|
poor |
1 |
|
self-reported deterioration |
better or same |
0 |
|
|
somewhat worse |
0.5 |
|
|
much worse |
1 |
|
vigorous activities |
not limited at all |
0 |
|
|
somewhat limited |
0.5 |
|
|
limited a lot |
1 |
|
moderate activities |
not limited at all |
0 |
|
|
somewhat limited |
0.5 |
|
|
limited a lot |
1 |
|
lifting or carrying groceries |
not limited at all |
0 |
|
|
somewhat limited |
0.5 |
|
|
limited a lot |
1 |
|
climbing stairs |
not limited at all |
0 |
|
|
somewhat limited |
0.5 |
|
|
limited a lot |
1 |
|
bending/kneeling/stooping |
not limited at all |
0 |
|
|
somewhat limited |
0.5 |
|
|
limited a lot |
1 |
|
walking 100 meters |
not limited at all |
0 |
|
|
somewhat limited |
0.5 |
|
|
limited a lot |
1 |
|
bathing or dressing |
not limited at all |
0 |
|
|
somewhat limited |
0.5 |
|
|
limited a lot |
1 |
|
self-rated fatigue |
none |
0 |
|
|
a little |
0.2 |
|
|
some |
0.4 |
|
|
moderate |
0.6 |
|
|
most |
0.8 |
|
|
always |
1 |
|
self-rated pain |
none |
0 |
|
|
very mild |
0.2 |
|
|
mild |
0.4 |
|
|
moderate |
0.6 |
|
|
severe |
0.8 |
|
|
very severe |
1 |
total score =
= SUM(points for all of the parameters)
average score =
= (total score) / 48
Interpretation:
• minimum total score: 0
• maximum total score: 48
• minimum average score: 0
• maximum average score: 1
• The higher the score the greater the risk of frailty.
Specialty: Sports Medicine & Rehabilitation
