{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T06:01:01Z","timestamp":1784700061166,"version":"3.55.0"},"reference-count":33,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T00:00:00Z","timestamp":1784073600000},"content-version":"vor","delay-in-days":14,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nephrology"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To compare four electronic health record (EHR)\u2010based frailty tools\u2014the Hospital Frailty Risk Score (HFRS), Johns Hopkins Adjusted Clinical Groups Frailty Indicator (CFI), Electronic Frailty Index (eFI) and a Laboratory\u2010based Frailty Index (FI\u2010Lab)\u2014in predicting progression and all\u2010cause mortality in hospitalised patients with chronic kidney disease (CKD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective study evaluated the indices in two cohorts: a single\u2010centre cohort (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20095715) for CKD progression and the Medical Information Mart for Intensive Care (MIMIC) database (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20092674) for mortality. We used Cox proportional hazards regression for association analyses. The incremental predictive value of adding frailty indices to established risk models was quantified using the area under the curve (AUC), net reclassification improvement (NRI) and integrated discrimination improvement (IDI).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Correlations between the frailty indices were weak to moderate (Spearman's\n                      <jats:italic>\u03c1<\/jats:italic>\n                      \u2009=\u20090.205\u20130.451). In adjusted analyses, CFI, eFI and FI\u2010Lab were associated with a higher risk of CKD progression, whereas HFRS was not. In the MIMIC cohort, all four indices were significantly associated with all\u2010cause mortality. Notably, the CFI association was non\u2010significant in patients\u2009&lt;\u200965\u2009years for both CKD progression and 28\u2010day mortality. For predictive enhancement, adding FI\u2010Lab and eFI to established CKD risk models significantly improved progression prediction (\u0394AUC\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05), yielding substantial reclassification (NRI: 0.376\u20130.498) and discrimination (IDI: 0.032\u20130.048). For mortality prediction, all indices improved baseline severity scores, with FI\u2010Lab providing the greatest incremental value.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Among the evaluated EHR\u2010based frailty indices, FI\u2010Lab offers the most robust utility for risk stratification in hospitalised patients with CKD, followed closely by eFI.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/nep.70232","type":"journal-article","created":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T15:15:26Z","timestamp":1784128526000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparison of Electronic Health Data\u2010Based Frailty Assessment Tools for Prediction of Adverse Outcomes of Patients With Chronic Kidney Disease"],"prefix":"10.1111","volume":"31","author":[{"given":"Ying","family":"Deng","sequence":"first","affiliation":[{"name":"Department of Nephrology Third Affiliated Hospital of Sun Yat\u2010Sen University  Guangzhou Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-8345-9347","authenticated-orcid":false,"given":"Jianhao","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Nephrology Third Affiliated Hospital of Sun Yat\u2010Sen University  Guangzhou Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0774-5817","authenticated-orcid":false,"given":"Xinghua","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Rheumatology Third Affiliated Hospital of Sun Yat\u2010Sen University  Guangzhou Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaomin","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Nephrology Third Affiliated Hospital of Sun Yat\u2010Sen University  Guangzhou Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hualiang","family":"Liang","sequence":"additional","affiliation":[{"name":"Department of Nephrology Third Affiliated Hospital of Sun Yat\u2010Sen University  Guangzhou Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7205-5540","authenticated-orcid":false,"given":"Leile","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Cardiology Third Affiliated Hospital of Sun Yat\u2010Sen University  Guangzhou Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2360-1429","authenticated-orcid":false,"given":"Xun","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Nephrology Third Affiliated Hospital of Sun Yat\u2010Sen University  Guangzhou Guangdong 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