To develop and internally validate a model for identifying Fried frailty in older patients with spinal tuberculosis using early in-hospital clinical information.
Approach:
Data Collection: Demographic characteristics, nutritional and inflammatory laboratory indicators, activities of daily living, and imaging burden were collected.
Model Performance Evaluation: Model performance was evaluated using discrimination, calibration, and decision curve analysis, with bootstrap resampling for internal validation.
Key Findings:
Among 323 patients, 260 were identified as frail, yielding a frailty prevalence of 80.50%.
Age, non-married status, and number of involved vertebrae were associated with higher odds of frailty.
Higher BMI and Barthel Index score were associated with lower odds of frailty.
The model's area under the receiver operating characteristic curve was 0.826.
Bootstrap internal validation showed a C-index of 0.826, with an optimism-corrected C-index of 0.812.
Interpretation:
The nomogram may serve as a screening and risk-stratification tool for identifying Fried frailty in older patients with spinal tuberculosis.
Limitations:
The study is a single-center retrospective analysis, which limits generalizability.
The model has not been externally validated.
Conclusion:
External validation and prospective studies are needed before broader clinical application.
A national claims analysis found modest uptake and declining persistence over 2 years despite increasing use of injectable HIV pre-exposure prophylaxis.
