ArticleScientific reports2025
Population-based validation of a frailty index using electronic regional healthcare records for public health use.
Article in Scientific reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
2 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Prognostic models in populations with heart failure: a systematic review and meta-analysis.Systematic reviews · 2026Pooled it
- Relative impact of multidomain lifestyle interventions on deficit accumulation frailty over 24 months in the U.S. POINTER trial.The journals of gerontology. Series A, Biological sciences and medical sciences · 2026Trial
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
Frailty indices derived from electronic health records offer an efficient approach to identify vulnerable individuals in the general population. We aimed to validate the electronic-regional healthcare database frailty index (e-RHD-FI) in the general adult population, describe its distribution by sex and age, evaluate its predictive validity for mortality, hospitalization and fragility fractures, and assess the performance of frailty cut-off points. We conducted a population-based study of 8,404,004 adult beneficiaries of the Lombardy Regional Health System. The e-RHD-FI was calculated from 40 health deficits using electronic health records from 2008 to 2018. We assessed its distribution, predictive validity for 1-year mortality, hospitalizations and fragility fractures through multi-state analysis and multivariable models evaluating performance across subgroups. The e-RHD-FI distribution was highly asymmetrical (median 0.0125, first-third quartiles 0-0.0375), with 45.8% of adults having no deficits. The index was higher in older adults. Each 0.1-point increment in e-RHD-FI was associated with doubled 1-year mortality risk (HR 2.12, 99% CI 2.11-2.14), 2.5-fold increased hospitalization rate (IRR 2.51, 99% CI 2.49-2.53), and a 55% higher risk of fragility fracture (HR 1.55, 99% CI 1.53-1.57). The AUC for 1-year mortality was 0.883 (99% CI 0.881-0.884). The e-RHD-FI demonstrates strong predictive validity for adverse outcomes in the general population and can effectively identify at-risk individuals for targeted interventions.
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