tetano
Editor, Senior Moderator
Age Ageing
. 2021 May 5;50(3):631-640.
doi: 10.1093/ageing/afab018.
Frailty is associated with in-hospital mortality in older hospitalised COVID-19 patients in the Netherlands: the COVID-OLD study
Laura C Blomaard[SUP] 1 [/SUP], Carolien M J van der Linden[SUP] 2 [/SUP], Jessica M van der Bol[SUP] 3 [/SUP], Steffy W M Jansen[SUP] 2 [/SUP], Harmke A Polinder-Bos[SUP] 4 [/SUP], Hanna C Willems[SUP] 5 [/SUP], Jan Festen[SUP] 6 [/SUP], Dennis G Barten[SUP] 7 [/SUP], Anke J Borgers[SUP] 8 [/SUP], Jeannet C Bos[SUP] 9 [/SUP], Frederiek van den Bos[SUP] 10 [/SUP], Esther J M de Brouwer[SUP] 8 [/SUP], Floor J A van Deudekom[SUP] 11 [/SUP], Suzanne C van Dijk[SUP] 12 [/SUP], Mari?lle H Emmelot-Vonk[SUP] 10 [/SUP], Raya E S Geels[SUP] 1 13 [/SUP], Esther M M van de Glind[SUP] 13 [/SUP], Bas de Groot[SUP] 14 [/SUP], Liesbeth Hempenius[SUP] 15 [/SUP], Ad M Kamper[SUP] 16 [/SUP], Linda M Kampschreur[SUP] 17 [/SUP], Marre M M de Koning[SUP] 12 [/SUP], Geert Labots[SUP] 18 [/SUP], Roy Looman[SUP] 19 [/SUP], Jacinta A Lucke[SUP] 20 [/SUP], Huub A A M Maas[SUP] 21 [/SUP], Francesco U S Mattace-Raso[SUP] 4 [/SUP], Rachida El Moussaoui[SUP] 22 [/SUP], Barbara C van Munster[SUP] 23 [/SUP], Cees van Nieuwkoop[SUP] 18 [/SUP], Leanne B L E Oosterwijk[SUP] 4 [/SUP], Marlies E M Regtuijt[SUP] 24 [/SUP], Sarah H M Robben[SUP] 21 [/SUP], Rikje Ruiter[SUP] 22 25 [/SUP], Aisha M Salarbaks[SUP] 24 [/SUP], Henrike J Schouten[SUP] 26 [/SUP], Orla M Smit[SUP] 19 [/SUP], Rosalinde A L Smits[SUP] 1 [/SUP], Petra E Spies[SUP] 26 [/SUP], Ralph Vreeswijk[SUP] 27 [/SUP], Oscar J de Vries[SUP] 11 [/SUP], Marjolein A Wijngaarden[SUP] 1 [/SUP], Caroline E Wyers[SUP] 28 [/SUP], Simon P Mooijaart[SUP] 1 [/SUP]
Affiliations
Abstract
Background: During the first wave of the coronavirus disease 2019 (COVID-19) pandemic, older patients had an increased risk of hospitalisation and death. Reports on the association of frailty with poor outcome have been conflicting.
Objective: The aim of the present study was to investigate the independent association between frailty and in-hospital mortality in older hospitalised COVID-19 patients in the Netherlands.
Methods: This was a multicentre retrospective cohort study in 15 hospitals in the Netherlands, including all patients aged ?70 years, who were hospitalised with clinically confirmed COVID-19 between February and May 2020. Data were collected on demographics, co-morbidity, disease severity and Clinical Frailty Scale (CFS). Primary outcome was in-hospital mortality.
Results: A total of 1,376 patients were included (median age 78 years (interquartile range 74-84), 60% male). In total, 499 (38%) patients died during hospital admission. Parameters indicating presence of frailty (CFS 6-9) were associated with more co-morbidities, shorter symptom duration upon presentation (median 4 versus 7 days), lower oxygen demand and lower levels of C-reactive protein. In multivariable analyses, the CFS was independently associated with in-hospital mortality: compared with patients with CFS 1-3, patients with CFS 4-5 had a two times higher risk (odds ratio (OR) 2.0 (95% confidence interval (CI) 1.3-3.0)) and patients with CFS 6-9 had a three times higher risk of in-hospital mortality (OR 2.8 (95% CI 1.8-4.3)).
Conclusions: The in-hospital mortality of older hospitalised COVID-19 patients in the Netherlands was 38%. Frailty was independently associated with higher in-hospital mortality, even though COVID-19 patients with frailty presented earlier to the hospital with less severe symptoms.
Keywords: COVID-19; SARS-CoV-2; clinical frailty scale; frailty; older adults.
. 2021 May 5;50(3):631-640.
doi: 10.1093/ageing/afab018.
Frailty is associated with in-hospital mortality in older hospitalised COVID-19 patients in the Netherlands: the COVID-OLD study
Laura C Blomaard[SUP] 1 [/SUP], Carolien M J van der Linden[SUP] 2 [/SUP], Jessica M van der Bol[SUP] 3 [/SUP], Steffy W M Jansen[SUP] 2 [/SUP], Harmke A Polinder-Bos[SUP] 4 [/SUP], Hanna C Willems[SUP] 5 [/SUP], Jan Festen[SUP] 6 [/SUP], Dennis G Barten[SUP] 7 [/SUP], Anke J Borgers[SUP] 8 [/SUP], Jeannet C Bos[SUP] 9 [/SUP], Frederiek van den Bos[SUP] 10 [/SUP], Esther J M de Brouwer[SUP] 8 [/SUP], Floor J A van Deudekom[SUP] 11 [/SUP], Suzanne C van Dijk[SUP] 12 [/SUP], Mari?lle H Emmelot-Vonk[SUP] 10 [/SUP], Raya E S Geels[SUP] 1 13 [/SUP], Esther M M van de Glind[SUP] 13 [/SUP], Bas de Groot[SUP] 14 [/SUP], Liesbeth Hempenius[SUP] 15 [/SUP], Ad M Kamper[SUP] 16 [/SUP], Linda M Kampschreur[SUP] 17 [/SUP], Marre M M de Koning[SUP] 12 [/SUP], Geert Labots[SUP] 18 [/SUP], Roy Looman[SUP] 19 [/SUP], Jacinta A Lucke[SUP] 20 [/SUP], Huub A A M Maas[SUP] 21 [/SUP], Francesco U S Mattace-Raso[SUP] 4 [/SUP], Rachida El Moussaoui[SUP] 22 [/SUP], Barbara C van Munster[SUP] 23 [/SUP], Cees van Nieuwkoop[SUP] 18 [/SUP], Leanne B L E Oosterwijk[SUP] 4 [/SUP], Marlies E M Regtuijt[SUP] 24 [/SUP], Sarah H M Robben[SUP] 21 [/SUP], Rikje Ruiter[SUP] 22 25 [/SUP], Aisha M Salarbaks[SUP] 24 [/SUP], Henrike J Schouten[SUP] 26 [/SUP], Orla M Smit[SUP] 19 [/SUP], Rosalinde A L Smits[SUP] 1 [/SUP], Petra E Spies[SUP] 26 [/SUP], Ralph Vreeswijk[SUP] 27 [/SUP], Oscar J de Vries[SUP] 11 [/SUP], Marjolein A Wijngaarden[SUP] 1 [/SUP], Caroline E Wyers[SUP] 28 [/SUP], Simon P Mooijaart[SUP] 1 [/SUP]
Affiliations
- PMID: 33951156
- DOI: 10.1093/ageing/afab018
Abstract
Background: During the first wave of the coronavirus disease 2019 (COVID-19) pandemic, older patients had an increased risk of hospitalisation and death. Reports on the association of frailty with poor outcome have been conflicting.
Objective: The aim of the present study was to investigate the independent association between frailty and in-hospital mortality in older hospitalised COVID-19 patients in the Netherlands.
Methods: This was a multicentre retrospective cohort study in 15 hospitals in the Netherlands, including all patients aged ?70 years, who were hospitalised with clinically confirmed COVID-19 between February and May 2020. Data were collected on demographics, co-morbidity, disease severity and Clinical Frailty Scale (CFS). Primary outcome was in-hospital mortality.
Results: A total of 1,376 patients were included (median age 78 years (interquartile range 74-84), 60% male). In total, 499 (38%) patients died during hospital admission. Parameters indicating presence of frailty (CFS 6-9) were associated with more co-morbidities, shorter symptom duration upon presentation (median 4 versus 7 days), lower oxygen demand and lower levels of C-reactive protein. In multivariable analyses, the CFS was independently associated with in-hospital mortality: compared with patients with CFS 1-3, patients with CFS 4-5 had a two times higher risk (odds ratio (OR) 2.0 (95% confidence interval (CI) 1.3-3.0)) and patients with CFS 6-9 had a three times higher risk of in-hospital mortality (OR 2.8 (95% CI 1.8-4.3)).
Conclusions: The in-hospital mortality of older hospitalised COVID-19 patients in the Netherlands was 38%. Frailty was independently associated with higher in-hospital mortality, even though COVID-19 patients with frailty presented earlier to the hospital with less severe symptoms.
Keywords: COVID-19; SARS-CoV-2; clinical frailty scale; frailty; older adults.