Frailty Screening Using the Risk Analysis Index: A User Guide

IF 2.3 Q2 HEALTH CARE SCIENCES & SERVICES Joint Commission journal on quality and patient safety Pub Date : 2024-12-19 DOI:10.1016/j.jcjq.2024.12.005

Daniel E. Hall MD, MDiv, MHSc, FACS (is Professor of Surgery and Anesthesiology & Perioperative Medicine, University of Pittsburgh, and Core Investigator, Center for Health Equity Research and Promotion, US Department of Veterans Affairs (VA) Pittsburgh Healthcare System.), Carly A. Jacobs MPH (is Health Science Specialist, Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System.), Katherine M. Reitz MD, MSc (is Assistant Professor of Surgery, University of Pittsburgh, and Vascular Surgeon, University of Pittsburgh Medical Center.), Shipra Arya MD, SM, FACS (is Professor, Department of Surgery, Stanford University School of Medicine, and Section Chief, Vascular Surgery, VA Palo Alto Healthcare System, Palo Alto, California.), Michael A. Jacobs MS (is Research Health Science Specialist, Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System.), John Cashy PhD (is Core Investigator, Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System.), Jason M. Johanning MD, MS, FACS (is Professor, University of Nebraska Medical Center, and Chief Surgical Consultant, Nebraska-Western Iowa VA Medical Center. Please address correspondence to Daniel E. Hall.)

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Abstract

The Risk Analysis Index (RAI) has emerged as the most thoroughly validated and flexible assessment of surgical frailty, proven feasible for at-scale bedside screening and available in a suite of tools, that effectively risk stratifies patients across a wide variety of clinical contexts and data sources. This user guide provides a definitive summary of the RAI's theoretical model, historical development, validation, statistical performance, and clinical interpretation, placing the RAI in context with other frailty assessments and emphasizing some of its advantages. Detailed instructions are provided for each RAI variant, along with a systematic review of existing RAI–related literature.

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