大量研究揭示了结直肠癌护理中与年龄相关的不平等。老龄化人口中日益严重的虚弱程度可能是造成这种情况的原因，但在基于人群的研究中量化虚弱具有挑战性。为了评估医院虚弱风险评分 (HFRS) 的可行性、有效性和可靠性，二级护理行政记录虚弱 ( SCARF）指数和国家结直肠癌队列中的衰弱综合征（FS）测量。基于人群的回顾性研究，使用了在英国国家卫生服务中心接受治疗的 136,008 名结直肠癌患者。每个测量值均在数据集中生成，以评估其可行性。将每项测量中使用的诊断代码与查尔森合并症指数 (CCI) 中的诊断代码进行比较。使用衰弱发生率及其与 1 年生存率的关系来评估有效性。 Brier评分和c统计量用于评估模型的性能和判别能力，其中包括每个测量。所有测量都证明了可行性、有效性和可靠性。 SCARF 和 CCI 中使用的诊断代码有相当大的重叠。每个人所确定的虚弱患病率各不相同； SCARF 将 55.4% 的人口分配到最低风险组，而这一比例为 85.1% (HFRS) 和 81.2% (FS)。 HFRS 和 FS 表明，虚弱程度最低和最高的患者的 1 年总生存率差异最大。模型性能的差异微乎其微。HFRS、SCARF 和 FS 在量化常规行政医疗保健数据集中的虚弱程度方面都具有价值。最合适的措施将取决于每项流行病学研究的背景和要求。© 作者 2024。由牛津大学出版社代表英国老年医学会出版。

Numerous studies have revealed age-related inequalities in colorectal cancer care. Increasing levels of frailty in an ageing population may be contributing to this, but quantifying frailty in population-based studies is challenging.To assess the feasibility, validity and reliability of the Hospital Frailty Risk Score (HFRS), the Secondary Care Administrative Records Frailty (SCARF) index and the frailty syndromes (FS) measures in a national colorectal cancer cohort.Retrospective population-based study using 136,008 patients with colorectal cancer treated within the English National Health Service.Each measure was generated in the dataset to assess their feasibility. The diagnostic codes used in each measure were compared with those in the Charlson Comorbidity Index (CCI). Validity was assessed using the prevalence of frailty and relationship with 1-year survival. The Brier score and the c-statistic were used to assess performance and discriminative ability of models with included each measure.All measures demonstrated feasibility, validity and reliability. Diagnostic codes used in SCARF and CCI have considerable overlap. Prevalence of frailty determined by each differed; SCARF allocating 55.4% of the population to the lowest risk group compared with 85.1% (HFRS) and 81.2% (FS). HFRS and FS demonstrated the greatest difference in 1-year overall survival between those with the lowest and highest measured levels of frailty. Differences in model performance were marginal.HFRS, SCARF and FS all have value in quantifying frailty in routine administrative health care datasets. The most suitable measure will depend on the context and requirements of each individual epidemiological study.© The Author(s) 2024. Published by Oxford University Press on behalf of the British Geriatrics Society.