期刊
AGE AND AGEING
卷 50, 期 2, 页码 307-316出版社
OXFORD UNIV PRESS
DOI: 10.1093/ageing/afaa167
关键词
COVID-19; frailty; cohort study; older people
资金
- National Institute for Health Research (NIHR Post-Doctoral Fellowship) [PDF-2015-08-102]
- UK National Institute for Health Research [NFSI-0512-10159]
This study aimed to describe outcomes in hospitalized older people with different levels of frailty and COVID-19 infection. The study analyzed 1,071 patients with COVID-19 test results, showing that COVID-19 infection dominated the hazard for death in older people, with a sevenfold hazard compared to those without COVID-19, while frailty appeared to make little incremental contribution to the hazard of dying.
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.
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