Background primary care screening for frailty status is recommended in clinical guidelines, but is impeded by doctor and nurse workloads and the lack of valid, easy-to-use and time-saving screening tools. Aim to develop and validate a new electronic tool (the electronic screening index of frailty, e-SIF) using routinely available electronic health data to automatically and massively identify frailty status in the population aged ≥65 years. Methods the e-SIF was developed in three steps: selection of clinical conditions; establishment of ICD-10 codes, criteria and algorithms for their definition; and electronic tool design and data extraction, transformation and load processes. The validation phase included an observational cohort study with retrospective data collection from computerised primary care medical records. The study population included inhabitants aged ≥65 years corresponding to three primary care centres (n = 9,315). Evaluated was the relationship between baseline e-SIF categories and mortality, institutionalisation, hospitalisation and health resource consumption after 2 years. Results according to the e-SIF, which includes 42 clinical conditions, frailty prevalence increases with age and is slightly greater in women. The 2-year adjusted hazard ratios for pre-frail, frail and very frail subjects, respectively, were as follows: 2.23 (95% CI: 1.74–2.85), 3.34 (2.44–4.56) and 6.49 (4.30–9.78) for mortality; 2.80 (2.39–3.27), 5.53 (4.59–6.65) and 9.14 (7.06–11.8) for hospitalisation; and 1.02 (0.70–1.49), 1.93 (1.21–3.08) and 2.69 (1.34–5.40) for institutionalisation. Conclusions the e-SIF shows good agreement with mortality, institutionalisation, hospitalisation and health resource consumption, indicating satisfactory validity. More studies in larger populations are needed to corroborate our findings.

中文翻译：

---

体弱者电子筛查指数的开发与验证

临床指南建议对虚弱状态进行背景初级保健筛查，但受到医生和护士工作量以及缺乏有效、易于使用和省时的筛查工具的阻碍。旨在开发和验证一种新的电子工具（衰弱的电子筛查指数，e-SIF），使用常规可用的电子健康数据自动和大规模识别 65 岁以上人群的衰弱状态。方法 e-SIF 的开发分三个步骤：选择临床条件；建立 ICD-10 代码、标准和算法以用于定义；电子工具设计和数据提取、转换和加载过程。验证阶段包括一项观察性队列研究，从计算机化的初级保健医疗记录中收集回顾性数据。研究人群包括年龄≥65 岁的居民，对应于三个初级保健中心（n = 9,315）。评估的是基线 e-SIF 类别与 2 年后死亡率、住院、住院和卫生资源消耗之间的关系。根据 e-SIF 的结果，包括 42 种临床情况，虚弱患病率随着年龄的增长而增加，女性的患病率略高。体弱前、体弱和非常虚弱受试者的 2 年调整风险比分别如下：死亡率为 2.23（95% CI：1.74-2.85）、3.34（2.44-4.56）和 6.49（4.30-9.78） ; 2.80 (2.39–3.27)、5.53 (4.59–6.65) 和 9.14 (7.06–11.8) 住院；和 1.02 (0.70–1.49)、1.93 (1.21–3.08) 和 2.69 (1.34–5.40) 用于制度化。结论 e-SIF 与死亡率、制度化、住院和卫生资源消耗，表明有效性令人满意。需要在更大的人群中进行更多的研究来证实我们的发现。