Validating SPICES as a Screening Tool for Frailty Risks among Hospitalized Older Adults
Table 3
Odds associated with positive frailty screen and selected validation measures ().
Validation measure
Odds ratio
95% Confidence interval
P value
Concurrent—criterion validity
Vulnerable Elders Survey-13 frail >3 (n = 90)
11.077**
4.542, 27.013
<0.001
Charlson Comorbidity Index ≥2 (n = 125)
3.171**
1.600, 6.283
0.001
Charlson Comorbidity Index ≥4 (n = 63)
2.322**
1.176, 4.582
0.001
Concurrent—construct validity
Age ≥ 80 years (n = 89)
4.345**
2.240, 8.430
<0.001
PHQ-2 screening ≥2 positive for depression (n = 55)
2.794**
1.364, 5.723
0.006
Admitted from a nursing home (n = 20)
1.235**
1.126, 1.355
<0.001
Prior hospital admission within 30 days (n = 48)
1.661
0.806, 3.382
0.220
2+ prior admissions within 6 months (n = 39)
1.253
0.592, 2.654
0.580
4+ active comorbid diagnoses, 1+ not controlled (n = 127)
2.794**
1.405, 5.557
0.004
≥7 prescription medications present on admission (n = 81)
2.916**
1.505, 5.649
0.004
Female gender (n = 102)
1.851
0.911, 3.456
0.058
Predictive validity
Expired during admission (n = 3)
1.028
0.996, 1.061
0.294
Any hospital adverse event* (n = 67)
3.041**
1.527, 6.054
0.001
Readmission within 30 days (n = 38)
1.235
0.580, 2.627
0.705
Adverse events summarized as one or more of the following: one or more falls (n = 5); hospital acquired pressure ulcer (n = 2); transfer to higher level of care (n = 10); complication from procedure (n = 9); any hospital acquired infection (n = 10); adverse drug reaction (n = 22); length of stay ≥7 days (n = 51). **indicates significant odds ratios.
