• Monica Pizzonia, Chiara Giannotti, Luca Carmisciano, Alessio Signori, Gianmarco Rosa, Federico Santolini, Irene Caffa, Fabrizio Montecucco, Alessio Nencioni, and Fiammetta Monacelli.
• IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
• Eur. J. Clin. Invest. 2021 Apr 1; 51 (4): e13445.

BackgroundThe primary aim of the study was determining the validation of the modified 19-item Frailty Index (mFI-19), based on the standard procedure for creating a frailty index scoring in the accumulation deficit theory of Rockwood and comparing it with the gold standard comprehensive geriatric assessment (CGA) in old age patients with hip fracture. As a secondary aim, we compared prognostic accuracies of mFI-19 and CGA in predicting long-term mortality after surgery.Materials And MethodsA total of 364 older patients with hip fractures, each a candidate for surgery, were consecutively enrolled. All were subjected to CGA and mFI-19 at baseline and time to death (years from hip surgery) were collected prospectively.ResultsMean patient age was 86.5 (SD: 5.65) years. The most common clinical phenotype (77%) was frail. Both CGA and mFI-19 performed similarly in predicting long-term mortality (Harrell's C-index: 0.66 and 0.68, respectively).ConclusionsThe mFI-19 was validated, compared to the gold standard CGA, based on a systematic process for creating a frailty index in relation to the accumulation deficit. This is one of few prospective studies addressing long-term mortality in older adults with hip fractures, invoking a methodologically robust frailty screening assessment.© 2020 Stichting European Society for Clinical Investigation Journal Foundation. Published by John Wiley & Sons Ltd.

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