To externally validate the Systemic Lupus International Collaborating Clinics Frailty Index (SLICC-FI) in a prevalent SLE cohort and to assess the ability of the SLICC-FI to predict organ damage accrual among individuals with longstanding SLE.
This was a secondary analysis of data from the Study of Lupus Vascular and Bone Long-Term Endpoints (SOLVABLE) cohort, which consists of adult women from the Chicago Lupus Database who met the 1997 revised ACR classification criteria for SLE. There were 185 SLE patients enrolled, of which 149 patients were included in a 5-year follow-up analysis. SLICC-FI and SLICC/ACR Damage Index (SDI) scores were calculated at baseline and 5-year follow-up. Unadjusted and adjusted logistic regression models estimated the association of baseline SLICC-FI scores (per 0.05 increase) with damage accrual at 5-year follow-up.
At enrollment the mean (SD) age of the 149 patients was 43.30 (10.15) years, mean (SD) disease duration was 11.93 (8.46) years, and mean (SD) SDI score was 1.64 (1.83). At baseline, the mean (SD) SLICC-FI score was 0.18 (0.08) and 36% of participants were categorized as frail (SLICC-FI >0.21). In a model adjusted for age, race and disease duration, each 0.05-unit increase in baseline SLICC-FI score was associated with a 39% higher odds of subsequent damage accrual (OR=1.39, 95% CI 1.05, 1.85).
In a prevalent cohort of women with established SLE, higher baseline SLICC-FI scores were associated with higher risk of subsequent damage accrual at 5-year follow up.