Updating and Validating the U.S. Veterans Affairs Frailty Index: Transitioning From ICD-9 to ICD-10.
J Gerontol A Biol Sci Med Sci
; 76(7): 1318-1325, 2021 06 14.
Article
in En
| MEDLINE
| ID: mdl-33693638
ABSTRACT
BACKGROUND:
The Veterans Affairs Frailty Index (VA-FI) is an electronic frailty index developed to measure frailty using administrative claims and electronic health records data in Veterans. An update to ICD-10 coding is needed to enable contemporary measurement of frailty.METHOD:
International Classification of Diseases, ninth revision (ICD-9) codes from the original VA-FI were mapped to ICD-10 first using the Centers for Medicaid and Medicare Services (CMS) General Equivalence Mappings. The resulting ICD-10 codes were reviewed by 2 geriatricians. Using a national cohort of Veterans aged 65 years and older, the prevalence of deficits contributing to the VA-FI and associations between the VA-FI and mortality over years 2012-2018 were examined.RESULTS:
The updated VA-FI-10 includes 6422 codes representing 31 health deficits. Annual cohorts defined on October 1 of each year included 2 266 191 to 2 428 115 Veterans, for which the mean age was 76 years, 97%-98% were male, 78%-79% were White, and the mean VA-FI was 0.20-0.22. The VA-FI-10 deficits showed stability before and after the transition to ICD-10 in 2015, and maintained strong associations with mortality. Patients classified as frail (VA-FI > 0.2) consistently had a hazard of death more than 2 times higher than nonfrail patients (VA-FI ≤ 0.1). Distributions of frailty and associations with mortality varied with and without linkage to CMS data and with different assessment periods for capturing deficits.CONCLUSIONS:
The updated VA-FI-10 maintains content validity, stability, and predictive validity for mortality in a contemporary cohort of Veterans aged 65 years and older, and may be applied to ICD-9 and ICD-10 claims data to measure frailty.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Veterans
/
International Classification of Diseases
/
Frailty
Type of study:
Risk_factors_studies
Limits:
Aged
/
Humans
/
Male
Country/Region as subject:
America do norte
Language:
En
Journal:
J Gerontol A Biol Sci Med Sci
Journal subject:
GERIATRIA
Year:
2021
Document type:
Article
Affiliation country:
Estados Unidos