Development, validation and performance of laboratory frailty indices: A scoping review

Introduction: Frailty is a syndrome characterised by decline in functional ability and increasing vulnerability to disease and associated with adverse outcomes. Several established methods exist for assessing frailty. This scoping review aims to characterise the development and validation of frailty indices based on laboratory test results (FI-Lab) and to assess their utility. Methods: Studies were included in the review if they included data concerning the development and/or testing an FI-Lab using the deficit accumulation method. Studies were identified using PubMed/MEDLINE, Embase (Elsevier), OpenGrey and Google Scholar from 2010 to 2021. Two reviewers independently screened all abstracts, and those that met the inclusion criteria were reviewed in detail. Data extracted included details about the study characteristics, number, type and coding of laboratory variables included, validation, and outcomes. A narrative synthesis of the available evidence was adopted. Results: The search yielded 915 articles, of which 29 studies were included. In general, 89% of studies were conducted after 2016 and 51% in a hospital-based setting. The number of variables included in FI-Labs ranged from 13 to 77, and 51% included some non-laboratory variables in their indices, with pulse and blood pressure being the most frequent. The validity of FI-Lab was demonstrated through change with age, correlation with established frailty indices and association with adverse health outcomes. The most frequent outcome studied was mortality (79% of the studies), with FI-Lab associated with increased mortality in all but one. Other outcomes studied included self-reported health, institutionalisation, and activities of daily living. The effect of combining the FI-Lab with a non-laboratory-based FI was assessed in 7 studies with a marginal increase in predictive ability. Conclusion: Frailty indices constructed based on the assessment of laboratory variables, appear to be a valid measure of frailty and robust to the choice of variables included

In situ instrumented posterolateral fusion without decompression in symptomatic low-grade isthmic spondylolisthesis in adults

Forty patients with an average age of 26.5 years were treated for symptomatic low-grade isthmic spondylolisthesis with in situ instrumented posterolateral fusion. All patients had failed previous conservative treatment. Average follow-up was 42.2 months (range: 30–62 months). Low-back pain resolved in 70% of the patients, whereas 65% of those with radicular pain reported complete resolution of the symptoms. At the final follow-up 82.5% of the patients had improvement in their function. Solid fusion was achieved in 70% of the patients. It was uncertain in 10% and a fusion failure was seen in 20%. The anterior slippage as measured by the Taillard method was 31.55% and an average 35% correction was seen after surgery. However, an average 10% loss of correction was seen at the final evaluation. The clinical results were evaluated by Kim and Kim criteria. Satisfactory results were obtained in 65% of patients and this was closely associated with the rate of successful fusion. The results suggest that clinical outcome is closely related to the attainment of solid fusion and decompression or removal of the loose laminar fragment seems unnecessary in patients without major neurological symptoms

Performance of cowpea varieties under Striga gesnerioides (Willd.) Vatke infestation using biplot analysis

Published online: 10 October 2017Striga gesnerioides (Willd) Vatke, is a major destructive parasitic weed of cowpea (Vigna unguiculata (L.) Walp.) which causes substantial yield reduction in West and Central Africa. The presence of different virulent races within the parasite population contributes to significant genotype × environment interaction, and complicates breeding for durable resistance to Striga. A 3-year study was conducted at three locations in the dry savanna agro-ecology of Nigeria, where Striga gesnerioides is endemic. The primary objective of the study was to identify cowpea genotypes with high yield under Striga infestation and yield stability across test environments and to access suitability of the test environment. Data collected on grain yield and yield components were subjected to analysis of variance (ANOVA). Means from ANOVA were subjected to the genotype main effect plus genotype × environment (GGE) biplot analysis to examine the multi-environment trial data and rank genotypes according to the environments. Genotypes, environment, and genotypes × environment interaction mean squares were significant for grain yield and yield components, and number of emerged Striga plants. The environment accounted for 35.01%, whereas the genotype × environment interaction accounted for 9.10% of the variation in grain yield. The GGE biplot identified UAM09 1046-6-1 (V7), and UAM09 1046-6-2 (V8), as ideal genotypes suggesting that these genotypes performed relatively well in all study environments and could be regarded as adapted to a wide range of locations. Tilla was the most repeatable and ideal location for selecting widely adapted genotypes for resistance to S. gesnerioides