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Article ; Online: Frailty and Mortality in Hospitalized Older Adults With COVID-19: Retrospective Observational Study.

De Smet, Robert / Mellaerts, Bea / Vandewinckele, Hannelore / Lybeert, Peter / Frans, Eric / Ombelet, Sara / Lemahieu, Wim / Symons, Rolf / Ho, Erwin / Frans, Johan / Smismans, Annick / Laurent, Michaël R

Journal of the American Medical Directors Association

2020 Volume 21, Issue 7, Page(s) 928–932.e1

Abstract: Objectives: To determine the association between frailty and short-term mortality in older adults ... hospitalized for coronavirus disease 2019 (COVID-19).: Design: Retrospective single-center observational ... study.: Setting and participants: Eighty-one patients with COVID-19 confirmed ...

Abstract	Objectives: To determine the association between frailty and short-term mortality in older adults hospitalized for coronavirus disease 2019 (COVID-19). Design: Retrospective single-center observational study. Setting and participants: Eighty-one patients with COVID-19 confirmed by reverse-transcriptase polymerase chain reaction (RT-PCR), at the Geriatrics department of a general hospital in Belgium. Measurements: Frailty was graded according to the Rockwood Clinical Frailty Scale (CFS). Demographic, biochemical, and radiologic variables, comorbidities, symptoms, and treatment were extracted from electronic medical records. Results: Participants (N = 48 women, 59%) had a median age of 85 years (range 65-97 years) and a median CFS score of 7 (range 2-9); 42 (52%) were long-term care residents. Within 6 weeks, 18 patients died. Mortality was significantly but weakly associated with age (Spearman r = 0.241, P = .03) and CFS score (r = 0.282, P = .011), baseline lactate dehydrogenase (LDH; r = 0.301, P = .009), lymphocyte count (r = -0.262, P = .02), and RT-PCR cycle threshold (Ct, r = -0.285, P = .015). Mortality was not associated with long-term care residence, dementia, delirium, or polypharmacy. In multivariable logistic regression analyses, CFS, LDH, and RT-PCR Ct (but not age) remained independently associated with mortality. Both age and frailty had poor specificity to predict survival. A multivariable model combining age, CFS, LDH, and viral load significantly predicted survival. Conclusions and implications: Although their prognosis is worse, even the oldest and most severely frail patients may benefit from hospitalization for COVID-19, if sufficient resources are available.
MeSH term(s)	Aged ; Aged, 80 and over ; Belgium/epidemiology ; COVID-19 ; Cohort Studies ; Coronavirus Infections/epidemiology ; Coronavirus Infections/prevention & control ; Disease Outbreaks/statistics & numerical data ; Female ; Frail Elderly ; Frailty/mortality ; Geriatric Assessment ; Hospital Mortality ; Hospitalization/statistics & numerical data ; Hospitals, General ; Humans ; Incidence ; Male ; Pandemics/prevention & control ; Pandemics/statistics & numerical data ; Pneumonia, Viral/epidemiology ; Pneumonia, Viral/prevention & control ; Retrospective Studies
Keywords	covid19
Language	English
Publishing date	2020-06-09
Publishing country	United States
Document type	Journal Article ; Observational Study
ZDB-ID	2171030-2
ISSN	1538-9375 ; 1525-8610
ISSN (online)	1538-9375
ISSN	1525-8610
DOI	10.1016/j.jamda.2020.06.008
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Article ; Online: Frailty and mortality in hospitalized older adults with COVID-19: retrospective observational study

De Smet, R. / Mellaerts, B. / Vandewinckele, H. / Lybeert, P. / Frans, E. / Ombelet, S. / Lemahieu, W. / Symons, R. / Ho, E. / Frans, J. / Smismans, A. / Laurent, M. R.

Abstract: ... frailty and short-term mortality in older adults hospitalized for COVID-19. Design: Retrospective single ... center observational study. Setting and participants: N = 81 patients with COVID-19 confirmed ... Background: Older adults with coronavirus disease 2019 (COVID-19) face an increased risk of adverse ...

Abstract	Background: Older adults with coronavirus disease 2019 (COVID-19) face an increased risk of adverse health outcomes including mortality. Ethical guidelines consider allocation of limited resources based on likelihood of survival, frailty, co-morbidities and age. However, the association of frailty with clinical outcomes in older COVID-19 patients remains unclear. Objectives: To determine the association between frailty and short-term mortality in older adults hospitalized for COVID-19. Design: Retrospective single-center observational study. Setting and participants: N = 81 patients with COVID-19 confirmed by reverse-transcriptase polymerase chain reaction (RT-PCR), at the Geriatrics department of Imelda general hospital, Belgium. Measurements: Frailty was graded according to the Rockwood Clinical Frailty Scale (CFS). Demographic, biochemical and radiological variables, co-morbidities, symptoms and treatment were extracted from electronic medical records. Results: Participants (N = 48 women, 59%) had a median age of 85 years (range 65 - 97 years), median CFS score of 7 (range 2 - 9), and 42 (52%) were long-term care residents. Within six weeks, eighteen patients died. Mortality was significantly but weakly associated with age (Spearman r = 0.241, P = 0.03) and CFS score (r = 0.282, P = 0.011), baseline lactate dehydrogenase (LDH) (r = 0.301, P = 0.009), lymphocyte count (r = -0.262, P = 0.02) and RT-PCR Ct value (r = -0.285, P = 0.015). Mortality was not associated with long-term care residence, dementia, delirium or polypharmacy. In multivariable logistic regression analyses, CFS, LDH and RT-PCR Ct values (but not age) remained independently associated with mortality. Both age and frailty had poor specificity to predict survival. A multivariable model combining age, CFS, LDH and viral load significantly predicted survival. Conclusions and implications: Although their prognosis is worse, even the oldest and most severely frail patients may benefit from hospitalization for COVID-19, if sufficient resources are available.
Keywords	covid19
Publisher	MedRxiv; WHO
Document type	Article ; Online
DOI	10.1101/2020.05.26.20113480
Database	COVID19

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Article ; Online: Frailty and mortality in hospitalized older adults with COVID-19: retrospective observational study

medRxiv

Abstract: ... frailty and short-term mortality in older adults hospitalized for COVID−19. Design: Retrospective single ... center observational study. Setting and participants: N = 81 patients with COVID−19 confirmed ... lymphocyte count (r = −0.262, P = 0.02) and RT-PCR Ct value (r = −0.285, P = 0.015). Mortality was not associated ...

Abstract	Background: Older adults with coronavirus disease 2019 (COVID−19) face an increased risk of adverse health outcomes including mortality. Ethical guidelines consider allocation of limited resources based on likelihood of survival, frailty, co−morbidities and age. However, the association of frailty with clinical outcomes in older COVID−19 patients remains unclear. Objectives: To determine the association between frailty and short-term mortality in older adults hospitalized for COVID−19. Design: Retrospective single-center observational study. Setting and participants: N = 81 patients with COVID−19 confirmed by reverse-transcriptase polymerase chain reaction (RT−PCR), at the Geriatrics department of Imelda general hospital, Belgium. Measurements: Frailty was graded according to the Rockwood Clinical Frailty Scale (CFS). Demographic, biochemical and radiological variables, co−morbidities, symptoms and treatment were extracted from electronic medical records. Results: Participants (N = 48 women, 59%) had a median age of 85 years (range 65 − 97 years), median CFS score of 7 (range 2 − 9), and 42 (52%) were long−term care residents. Within six weeks, eighteen patients died. Mortality was significantly but weakly associated with age (Spearman r = 0.241, P = 0.03) and CFS score (r = 0.282, P = 0.011), baseline lactate dehydrogenase (LDH) (r = 0.301, P = 0.009), lymphocyte count (r = −0.262, P = 0.02) and RT-PCR Ct value (r = −0.285, P = 0.015). Mortality was not associated with long-term care residence, dementia, delirium or polypharmacy. In multivariable logistic regression analyses, CFS, LDH and RT-PCR Ct values (but not age) remained independently associated with mortality. Both age and frailty had poor specificity to predict survival. A multivariable model combining age, CFS, LDH and viral load significantly predicted survival. Conclusions and implications: Although their prognosis is worse, even the oldest and most severely frail patients may benefit from hospitalization for COVID−19, if sufficient resources are available.
Keywords	covid19
Language	English
Publishing date	2020-05-27
Publisher	Cold Spring Harbor Laboratory Press
Document type	Article ; Online
DOI	10.1101/2020.05.26.20113480
Database	COVID19

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Article ; Online: Frailty and hyperactive delirium in hospitalized older patients with COVID-19: an insight from GeroCovid registry.

Parrotta, Ilaria / Bencivenga, Leonardo / Okoye, Chukwuma / Bellelli, Giuseppe / Fumagalli, Stefano / Mossello, Enrico / Antonelli Incalzi, Raffaele

Aging clinical and experimental research

2023 Volume 35, Issue 2, Page(s) 433–442

Abstract: ... hospitalized for COVID-19.: Aim: To identify biological correlates of HD at hospital admission and to assess ... the independent effect of delirium and physical frailty on in-hospital mortality.: Methods: Data were ... older adults were included in the analysis [mean age (SD) 77.1 (9.5) years, 50.1% females], and 11.5 ...

Abstract	Background: Delirium is an acute neuropsychiatric condition associated with unfavourable outcomes, frequent in older hospitalized people. In the context of the SARS-CoV-2 pandemic, few studies have specifically focused on the inflammatory status of older, frail patients with hyperactive delirium (HD) hospitalized for COVID-19. Aim: To identify biological correlates of HD at hospital admission and to assess the independent effect of delirium and physical frailty on in-hospital mortality. Methods: Data were retrospectively extracted by the multicenter registry GeroCovid Observational Study. Individuals aged ≥ 60 years were included if the information on the presence of HD, frailty based on the modified Fried criteria and inflammatory status had been collected. The risk of mortality was evaluated using a Kaplan-Meier estimator, according to frailty and delirium. Logistic and restricted cubic-spline regressions were employed to assess the relationship between inflammatory markers and HD. Results: Three-hundred-thirty-seven older adults were included in the analysis [mean age (SD) 77.1 (9.5) years, 50.1% females], and 11.5% presented with HD. A significant association of both PaO Conclusions: Hyperactive delirium at hospital admission is related with markers of lung failure among older adults, especially when physical frailty coexists. Delirium is associated with increased in-hospital mortality risk, which is doubled by the coexistence of physical frailty.
MeSH term(s)	Aged ; Female ; Humans ; Male ; Frailty/complications ; COVID-19/complications ; Frail Elderly/psychology ; Retrospective Studies ; Delirium ; Risk Factors ; SARS-CoV-2 ; Geriatric Assessment
Language	English
Publishing date	2023-01-04
Publishing country	Germany
Document type	Observational Study ; Multicenter Study ; Journal Article
ZDB-ID	2104785-6
ISSN	1720-8319 ; 1594-0667
ISSN (online)	1720-8319
ISSN	1594-0667
DOI	10.1007/s40520-022-02328-0
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Article ; Online: Clinical Features, Inpatient Trajectories and Frailty in Older Inpatients with COVID-19: A Retrospective Observational Study.

Osuafor, Christopher N / Davidson, Catriona / Mackett, Alistair J / Goujon, Marie / Van Der Poel, Lelane / Taylor, Vince / Preller, Jacobus / Goudie, Robert J B / Keevil, Victoria L

Geriatrics (Basel, Switzerland)

2021 Volume 6, Issue 1

Abstract: ... hospitalized with COVID-19 and explore relationships with frailty.: Methods: This retrospective ... observational study included older adults admitted as an emergency to a University Hospital who were diagnosed ... should have a low threshold for testing for COVID-19 in older and frail patients during periods of community ...

Abstract	Introduction: We describe the clinical features and inpatient trajectories of older adults hospitalized with COVID-19 and explore relationships with frailty. Methods: This retrospective observational study included older adults admitted as an emergency to a University Hospital who were diagnosed with COVID-19. Patient characteristics and hospital outcomes, primarily inpatient death or death within 14 days of discharge, were described for the whole cohort and by frailty status. Associations with mortality were further evaluated using Cox Proportional Hazards Regression (Hazard Ratio (HR), 95% Confidence Interval). Results: 214 patients (94 women) were included of whom 142 (66.4%) were frail with a median Clinical Frailty Scale (CFS) score of 6. Frail compared to nonfrail patients were more likely to present with atypical symptoms including new or worsening confusion (45.1% vs. 20.8%, Conclusions: Clinicians should have a low threshold for testing for COVID-19 in older and frail patients during periods of community viral transmission, and diagnosis should prompt early advanced care planning.
Language	English
Publishing date	2021-02-01
Publishing country	Switzerland
Document type	Journal Article
ISSN	2308-3417
ISSN (online)	2308-3417
DOI	10.3390/geriatrics6010011
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Article ; Online: Frailty and Mortality in Hospitalized Older Adults With COVID-19

Journal of the American Medical Directors Association

Retrospective Observational Study

2020 Volume 21, Issue 7, Page(s) 928–932.e1

Keywords	General Nursing ; Health Policy ; General Medicine ; covid19
Language	English
Publisher	Elsevier BV
Publishing country	us
Document type	Article ; Online
ZDB-ID	2171030-2
ISSN	1538-9375 ; 1525-8610
ISSN (online)	1538-9375
ISSN	1525-8610
DOI	10.1016/j.jamda.2020.06.008
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Article ; Online: Association between Clinical Frailty Scale score and hospital mortality in adult patients with COVID-19 (COMET): an international, multicentre, retrospective, observational cohort study.

Sablerolles, Roos S G / Lafeber, Melvin / van Kempen, Janneke A L / van de Loo, Bob P A / Boersma, Eric / Rietdijk, Wim J R / Polinder-Bos, Harmke A / Mooijaart, Simon P / van der Kuy, Hugo / Versmissen, Jorie / Faes, Miriam C

The lancet. Healthy longevity

2021 Volume 2, Issue 3, Page(s) e163–e170

Abstract: ... hospital mortality and between CFS score and admission to intensive care in adult patients of all ages with COVID-19 ... for hospital mortality in adult patients with COVID-19. However, treatment decisions based on the CFS in patients younger ... an international, multicentre, retrospective observational cohort study in 63 hospitals in 11 countries in Europe ...

Abstract	Background: During the COVID-19 pandemic, the scarcity of resources has necessitated triage of critical care for patients with the disease. In patients aged 65 years and older, triage decisions are regularly based on degree of frailty measured by the Clinical Frailty Scale (CFS). However, the CFS could also be useful in patients younger than 65 years. We aimed to examine the association between CFS score and hospital mortality and between CFS score and admission to intensive care in adult patients of all ages with COVID-19 across Europe. Methods: This analysis was part of the COVID Medication (COMET) study, an international, multicentre, retrospective observational cohort study in 63 hospitals in 11 countries in Europe. Eligible patients were aged 18 years and older, had been admitted to hospital, and either tested positive by PCR for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or were judged to have a high clinical likelihood of having SARS-CoV-2 infection by the local COVID-19 expert team. CFS was used to assess level of frailty: fit (CFS Findings: Between March 30 and July 15, 2020, 2434 patients (median age 68 years [IQR 55-77]; 1480 [61%] men, 954 [30%] women) had CFS scores available and were included in the analyses. In the total sample and in patients aged 65 years and older, frail patients and mildly frail patients had a significantly higher risk of hospital mortality than fit patients (total sample: CFS Interpretation: The results of this study suggest that CFS score is a suitable risk marker for hospital mortality in adult patients with COVID-19. However, treatment decisions based on the CFS in patients younger than 65 years should be made with caution. Funding: LOEY Foundation.
MeSH term(s)	Adult ; Aged ; COVID-19 ; Cohort Studies ; Female ; Frailty ; Hospital Mortality ; Humans ; Length of Stay ; Male ; Pandemics ; Retrospective Studies ; SARS-CoV-2
Language	English
Publishing date	2021-02-09
Publishing country	England
Document type	Journal Article ; Multicenter Study ; Observational Study ; Research Support, Non-U.S. Gov't
ISSN	2666-7568
ISSN (online)	2666-7568
DOI	10.1016/S2666-7568(21)00006-4
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Article ; Online: Association between Clinical Frailty Scale score and hospital mortality in adult patients with COVID-19 (COMET)

Roos S G Sablerolles, MD / Melvin Lafeber, MD / Janneke A L van Kempen, MD / Bob P A van de Loo, Msc / Eric Boersma, ProfPhD / Wim J R Rietdijk, PhD / Harmke A Polinder-Bos, MD / Simon P Mooijaart, MD / Hugo van der Kuy, ProfPharmD / Jorie Versmissen, MD / Miriam C Faes, MD / LA Agnoletto / J Aleman / S Andreassi / LM Andrews / L Ashfield / H Bell / AKB Bengaard / SB Berlinghini /

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The Lancet. Healthy Longevity, Vol 2, Iss 3, Pp e163-e

an international, multicentre, retrospective, observational cohort study

2021 Volume 170

Abstract: ... for hospital mortality in adult patients with COVID-19. However, treatment decisions based on the CFS in patients younger ... COMET) study, an international, multicentre, retrospective observational cohort study in 63 hospitals ... between CFS score and hospital mortality and between CFS score and admission to intensive care in adult ...

Abstract	Summary: Background: During the COVID-19 pandemic, the scarcity of resources has necessitated triage of critical care for patients with the disease. In patients aged 65 years and older, triage decisions are regularly based on degree of frailty measured by the Clinical Frailty Scale (CFS). However, the CFS could also be useful in patients younger than 65 years. We aimed to examine the association between CFS score and hospital mortality and between CFS score and admission to intensive care in adult patients of all ages with COVID-19 across Europe. Methods: This analysis was part of the COVID Medication (COMET) study, an international, multicentre, retrospective observational cohort study in 63 hospitals in 11 countries in Europe. Eligible patients were aged 18 years and older, had been admitted to hospital, and either tested positive by PCR for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or were judged to have a high clinical likelihood of having SARS-CoV-2 infection by the local COVID-19 expert team. CFS was used to assess level of frailty: fit (CFS1–3), mildly frail (CFS4–5), or frail (CFS6–9). The primary outcome was hospital mortality. The secondary outcome was admission to intensive care. Data were analysed using a multivariable binary logistic regression model adjusted for covariates (age, sex, number of drugs prescribed, and type of drug class as a proxy for comorbidities). Findings: Between March 30 and July 15, 2020, 2434 patients (median age 68 years [IQR 55–77]; 1480 [61%] men, 954 [30%] women) had CFS scores available and were included in the analyses. In the total sample and in patients aged 65 years and older, frail patients and mildly frail patients had a significantly higher risk of hospital mortality than fit patients (total sample: CFS6–9 vs CFS1–3 odds ratio [OR] 2·71 [95% CI 2·04–3·60], p<0·0001 and CFS4–5 vs CFS1–3 OR 1·54 [1·16–2·06], p=0·0030; age ≥65 years: CFS6–9 vs CFS1–3 OR 2·90 [2·12–3·97], p<0·0001 and CFS4–5 vs CFS1–3 OR 1·64 [1·20–2·25], p=0·0020). In patients younger than 65 years, an increased hospital mortality risk was only observed in frail patients (CFS6–9 vs CFS1–3 OR 2·22 [1·08–4·57], p=0·030; CFS4–5 vs CFS1–3 OR 1·08 [0·48–2·39], p=0·86). Frail patients had a higher incidence of admission to intensive care than fit patients (CFS6–9 vs CFS1–3 OR 1·54 [1·21–1·97], p=0·0010), whereas mildly frail patients had a lower incidence than fit patients (CFS4–5 vs CFS1–3 OR 0·71 [0·55–0·92], p=0·0090). Among patients younger than 65 years, frail patients had an increased incidence of admission to intensive care (CFS6–9 vs CFS1–3 OR 2·96 [1·98–4·43], p<0·0001), whereas mildly frail patients had no significant difference in incidence compared with fit patients (CFS4–5 vs CFS1–3 OR 0·93 [0·63–1·38], p=0·72). Among patients aged 65 years and older, frail patients had no significant difference in the incidence of admission to intensive care compared with fit patients (CFS6–9 vs CFS1–3 OR 1·27 [0·92–1·75], p=0·14), whereas mildly frail patients had a lower incidence than fit patients (CFS4–5 vs CFS1–3 OR 0·66 [0·47–0·93], p=0·018). Interpretation: The results of this study suggest that CFS score is a suitable risk marker for hospital mortality in adult patients with COVID-19. However, treatment decisions based on the CFS in patients younger than 65 years should be made with caution. Funding: LOEY Foundation.
Keywords	Geriatrics ; RC952-954.6 ; Medicine ; R
Subject code	610 ; 616
Language	English
Publishing date	2021-03-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
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Article ; Online: Comparing associations between frailty and mortality in hospitalised older adults with or without COVID-19 infection: a retrospective observational study using electronic health records.

Owen, Rhiannon K / Conroy, Simon P / Taub, Nicholas / Jones, Will / Bryden, Daniele / Pareek, Manish / Faull, Christina / Abrams, Keith R / Davis, Daniel / Banerjee, Jay

Age and ageing

2020 Volume 50, Issue 2, Page(s) 307–316

Abstract: ... cohort study examining COVID-19-related mortality using electronic health records, for older people (65 and ... people with different levels of frailty and COVID-19 infection.: Methods: We undertook a single-centre, retrospective ... to the hazard of dying in older people hospitalised with COVID-19 infection; illness severity and comorbidity ...

Abstract	Background: The aim of this study was to describe outcomes in hospitalised older people with different levels of frailty and COVID-19 infection. Methods: We undertook a single-centre, retrospective cohort study examining COVID-19-related mortality using electronic health records, for older people (65 and over) with frailty, hospitalised with or without COVID-19 infection. Baseline covariates included demographics, early warning scores, Charlson Comorbidity Indices and frailty (Clinical Frailty Scale, CFS), linked to COVID-19 status. Findings: We analysed outcomes on 1,071 patients with COVID-19 test results (285 (27%) were positive for COVID-19). The mean age at ED arrival was 79.7 and 49.4% were female. All-cause mortality (by 30 days) rose from 9 (not frail) to 33% (severely frail) in the COVID-negative cohort but was around 60% for all frailty categories in the COVID-positive cohort. In adjusted analyses, the hazard ratio for death in those with COVID-19 compared to those without COVID-19 was 7.3 (95% CI: 3.00, 18.0) with age, comorbidities and illness severity making small additional contributions. Interpretation: In this study, frailty measured using the CFS appeared to make little incremental contribution to the hazard of dying in older people hospitalised with COVID-19 infection; illness severity and comorbidity had a modest association with the overall adjusted hazard of death, whereas confirmed COVID-19 infection dominated, with a sevenfold hazard for death.
MeSH term(s)	Aged ; COVID-19/mortality ; COVID-19/therapy ; Comorbidity ; Early Warning Score ; Electronic Health Records/statistics & numerical data ; Female ; Frail Elderly/statistics & numerical data ; Frailty/diagnosis ; Frailty/epidemiology ; Geriatric Assessment/methods ; Geriatric Assessment/statistics & numerical data ; Hospital Mortality ; Hospitalization/statistics & numerical data ; Humans ; Male ; Proportional Hazards Models ; Retrospective Studies ; SARS-CoV-2/isolation & purification ; Severity of Illness Index ; United Kingdom/epidemiology
Keywords	covid19
Language	English
Publishing date	2020-07-16
Publishing country	England
Document type	Journal Article ; Observational Study ; Research Support, Non-U.S. Gov't
ZDB-ID	186788-x
ISSN	1468-2834 ; 0002-0729
ISSN (online)	1468-2834
ISSN	0002-0729
DOI	10.1093/ageing/afaa167
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Order via subito

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Inter-library loan at ZB MED

More links

Kategorien

In stock of ZB MED Cologne/Königswinter

Order via subito