Age and frailty are independently associated with increased covid-19 mortality and increased care needs in survivors: results of an international multi-centre study
Age and frailty are independently associated with increased covid-19 mortality and increased care needs in survivors: results of an international multi-centre study
Introduction: Increased mortality has been demonstrated in older adults with coronavirus disease 2019 (COVID-19), but the effect of frailty has been unclear. Methods: This multi-centre cohort study involved patients aged 18 years and older hospitalised with COVID-19, using routinely collected data. We used Cox regression analysis to assess the impact of age, frailty and delirium on the risk of inpatient mortality, adjusting for sex, illness severity, inflammation and co-morbidities. We used ordinal logistic regression analysis to assess the impact of age, Clinical Frailty Scale (CFS) and delirium on risk of increased care requirements on discharge, adjusting for the same variables. Results: Data from 5,711 patients from 55 hospitals in 12 countries were included (median age 74, interquartile range [IQR] 54 83; 55.2% male). The risk of death increased independently with increasing age (>80 versus 18 49: hazard ratio [HR] 3.57, confidence interval [CI] 2.54 5.02), frailty (CFS 8 versus 1 3: HR 3.03, CI 2.29 4.00) inflammation, renal disease, cardiovascular disease and cancer, but not delirium. Age, frailty (CFS 7 versus 1 3: odds ratio 7.00, CI 5.27 9.32), delirium, dementia and mental health diagnoses were all associated with increased risk of higher care needs on discharge.The likelihood of adverse outcomes increased across all grades of CFS from 4 to 9. Conclusion: Age and frailty are independently associated with adverse outcomes in COVID-19. Risk of increased care needs was also increased in survivors of COVID-19 with frailty or older age.
delirium, frailty,COVID-19, mortality, transitions of care
617-630
Lim, Stephen
dd2bfbd7-7f74-4365-b77e-9989f6408ddc
Geriatric Medicine Research Collaborative
5 May 2021
Lim, Stephen
dd2bfbd7-7f74-4365-b77e-9989f6408ddc
Geriatric Medicine Research Collaborative
(2021)
Age and frailty are independently associated with increased covid-19 mortality and increased care needs in survivors: results of an international multi-centre study.
Age and Ageing, 50 (3), .
(doi:10.1093/ageing/afab026).
Abstract
Introduction: Increased mortality has been demonstrated in older adults with coronavirus disease 2019 (COVID-19), but the effect of frailty has been unclear. Methods: This multi-centre cohort study involved patients aged 18 years and older hospitalised with COVID-19, using routinely collected data. We used Cox regression analysis to assess the impact of age, frailty and delirium on the risk of inpatient mortality, adjusting for sex, illness severity, inflammation and co-morbidities. We used ordinal logistic regression analysis to assess the impact of age, Clinical Frailty Scale (CFS) and delirium on risk of increased care requirements on discharge, adjusting for the same variables. Results: Data from 5,711 patients from 55 hospitals in 12 countries were included (median age 74, interquartile range [IQR] 54 83; 55.2% male). The risk of death increased independently with increasing age (>80 versus 18 49: hazard ratio [HR] 3.57, confidence interval [CI] 2.54 5.02), frailty (CFS 8 versus 1 3: HR 3.03, CI 2.29 4.00) inflammation, renal disease, cardiovascular disease and cancer, but not delirium. Age, frailty (CFS 7 versus 1 3: odds ratio 7.00, CI 5.27 9.32), delirium, dementia and mental health diagnoses were all associated with increased risk of higher care needs on discharge.The likelihood of adverse outcomes increased across all grades of CFS from 4 to 9. Conclusion: Age and frailty are independently associated with adverse outcomes in COVID-19. Risk of increased care needs was also increased in survivors of COVID-19 with frailty or older age.
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e-pub ahead of print date: 5 February 2021
Published date: 5 May 2021
Keywords:
delirium, frailty,COVID-19, mortality, transitions of care
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Local EPrints ID: 447446
URI: http://eprints.soton.ac.uk/id/eprint/447446
ISSN: 0002-0729
PURE UUID: 5a55e97d-597d-4318-952c-fa5b6bd3af10
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Date deposited: 11 Mar 2021 17:36
Last modified: 17 Mar 2024 06:20
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Corporate Author: Geriatric Medicine Research Collaborative
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