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Objective: The aim was to explore the effectiveness of the International Myeloma Working Group Frailty Index (IMWG-FI), Mayo Score, UK Myeloma Research Alliance Risk Profile (MRP), and Intergroupe Francophone du Myélome (IFM) simplified frailty scale for classifying frailty in elderly multiple myeloma (MM) patients and compare the validity of different frailty tools.
Methods: Eighty-four newly diagnosed MM patients aged ≥ 60 years in HeBei University Hospital were evaluated by the IMWG-FI, Mayo score, MRP score and IFM scale, and consistency and survival analyses were performed using Cohen's kappa coefficients and the Kaplan‒Meier method, respectively.
Results: A total of 64 patients (76.2%) were identified as frail by at least one frailty tool; 14 (21.9%) were identified as frail by all four tools, and although moderate concordance was achieved between the IMWG-FI and MRP and the Mayo Score (0.432-0.474, P < 0.001), the concordance among the four assessment tools was relatively low (Cohen's kappa 0.218-0.474). The median overall survival (OS, P = 0.006, 0.025, and 0.028) and progression-free survival (PFS, P = 0.002, 0.006, and 0.03) of patients in the frail group and the nonfrail group identified by the IMWG-FI, Mayo score, and MRP were significantly different, while the median OS (P = 0.139) and PFS (P = 0.167) were not significantly different for the frail patients identified by the different frailty assessment tools.
Conclusion: In this study, the consistency of the different frailty assessment tools was low, whereas that between the MRP and IMWG-FI was high. Therefore, combining IMWG-FI and MRP may reduce assessment subjectivity and improve frailty identification.
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http://dx.doi.org/10.1007/s12672-024-01305-5 | DOI Listing |
Am J Emerg Med
September 2025
University of Toronto, Rotman School of Management, Canada.
Study Objective: Accurately predicting which Emergency Department (ED) patients are at high risk of leaving without being seen (LWBS) could enable targeted interventions aimed at reducing LWBS rates. Machine Learning (ML) models that dynamically update these risk predictions as patients experience more time waiting were developed and validated, in order to improve the prediction accuracy and correctly identify more patients who LWBS.
Methods: The study was deemed quality improvement by the institutional review board, and collected all patient visits to the ED of a large academic medical campus over 24 months.
Hepatology
September 2025
Department of Gastroenterology and Hepatology, UT Southwestern, Dallas, TX.
Background: The clinical course and outcomes of alcohol-associated hepatitis (AH) remain poorly understood. Major adverse liver outcomes (MALO) do not capture the added risk of return to drinking (RTD). We examined the natural history of AH and developed a composite endpoint using a contemporary observational cohort of AH.
View Article and Find Full Text PDFJAMA Netw Open
September 2025
Department of Internal Medicine, University of Arkansas for Medical Sciences, Little Rock.
Importance: Patients with kidney failure (KF) receiving long-term dialysis have increased incidence of atrial fibrillation (AF). Patients with KF and AF have increased risk of stroke, death, and bleeding compared with age-matched cohorts. In KF, the use of oral anticoagulants (OACs) increases hemorrhage risk, offsetting potential benefits and making left atrial appendage occlusion (LAAO) a potentially promising solution for risk reduction in AF.
View Article and Find Full Text PDFWorkplace Health Saf
September 2025
Care Delivery Research, Allina Health.
Background: Effective communication and collaboration among clinical and nonclinical staff are critical to the health and safety of the staff, for optimal team performance and for safe patient care. While respiratory protective equipment are routine key strategies to protect healthcare workers from exposure to select respiratory pathogens, they have been demonstrated to disrupt speech intelligibility. The COVID-19 pandemic escalated the need for and utilization of respiratory protection in all healthcare settings.
View Article and Find Full Text PDFLiver Int
October 2025
Hannover Medical School, Department of Diagnostic and Interventional Radiology, Hannover, Germany.
Background And Aims: We aimed to ascertain the prevalence of sarcopenia in patients with primary sclerosing cholangitis (PSC) and to assess the prognostic value as a biomarker for disease outcome.
Methods: We collected data from 224 patients (148 male, 76 female; mean age 41 years) from January 2002 to December 2021, with a confirmed diagnosis of PSC who underwent magnetic resonance imaging (MRI). Muscle mass was quantified at the level of the third lumbar vertebra by measurement of psoas muscle thickness (PMT) and total psoas muscle area (PMA).