Association of frailty with mortality in older inpatients with Covid-19: a cohort study
Abstract Background COVID-19 has disproportionately affected older people. Objective The objective of this paper to investigate whether frailty is associated with all-cause mortality in older hospital inpatients, with COVID-19. Design Cohort study. Setting Secondary care acute hospital. Participants...
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| Veröffentlicht in: | Age and ageing 2020-11, Vol.49 (6), p.915-922 |
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| creator | Aw, Darren Woodrow, Lauren Ogliari, Giulia Harwood, Rowan |
| description | Abstract
Background
COVID-19 has disproportionately affected older people.
Objective
The objective of this paper to investigate whether frailty is associated with all-cause mortality in older hospital inpatients, with COVID-19.
Design
Cohort study.
Setting
Secondary care acute hospital.
Participants
Participants included are 677 consecutive inpatients aged 65 years and over.
Methods
Cox proportional hazards models were used to examine the association of frailty with mortality. Frailty was assessed at baseline, according to the Clinical Frailty Scale (CFS), where higher categories indicate worse frailty. Analyses were adjusted for age, sex, deprivation, ethnicity, previous admissions and acute illness severity.
Results
Six hundred and sixty-four patients were classified according to CFS. Two hundred and seventy-one died, during a mean follow-up of 34.3 days. Worse frailty at baseline was associated with increased mortality risk, even after full adjustment (P = 0.004). Patients with CFS 4 and CFS 5 had non-significant increased mortality risks, compared to those with CFS 1–3. Patients with CFS 6 had a 2.13-fold (95% CI 1.34–3.38) and those with CFS 7–9 had a 1.79-fold (95% CI 1.12–2.88) increased mortality risk, compared to those with CFS 1–3 (P = 0.001 and 0.016, respectively). Older age, male sex and acute illness severity were also associated with increased mortality risk.
Conclusions
Frailty is associated with all-cause mortality risk in older inpatients with COVID-19. |
| doi_str_mv | 10.1093/ageing/afaa184 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7454254</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><oup_id>10.1093/ageing/afaa184</oup_id><sourcerecordid>2432854812</sourcerecordid><originalsourceid>FETCH-LOGICAL-c452t-aa6765c3d8e7078a1e1121a6d82562b7caee5fc748a983f6fe825fdf2c8f5b4f3</originalsourceid><addsrcrecordid>eNqFkUtLxDAUhYMoOj62LqXgRhfVJE2a1IUwDL5AcKO4DHfSZCbSacakVebfG-ko6sZVcjnfPZzLQeiQ4DOCq-IcZsa1s3OwAESyDTQirJQ5lQXbRCOMMc2xoNUO2o3xJY2EE7qNdgoqhJQCj9DzOEavHXTOt5m3mQ3gmm6Vvbtuni186KBxaXRJbGoT0meZWNN2cUAm_s3VOakuMsi0n6eFLHZ9vdpHWxaaaA7W7x56ur56nNzm9w83d5Pxfa4Zp10OUIqS66KWRmAhgRhCKIGylpSXdCo0GMOtFkxCJQtbWpMEW1uqpeVTZos9dDn4LvvpwtQ6JQvQqGVwCwgr5cGp30rr5mrm35RgnFHOksHJ2iD4197ETi1c1KZpoDW-j4qygkrOJKEJPf6Dvvg-tOm8RIkyJZfVp-HZQOngYwzGfochWH12pobO1LqztHD084Rv_KukBJwOgO-X_5l9AGXvpAs</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2476112894</pqid></control><display><type>article</type><title>Association of frailty with mortality in older inpatients with Covid-19: a cohort study</title><source>Applied Social Sciences Index & Abstracts (ASSIA)</source><source>Oxford University Press Journals All Titles (1996-Current)</source><source>MEDLINE</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Alma/SFX Local Collection</source><creator>Aw, Darren ; Woodrow, Lauren ; Ogliari, Giulia ; Harwood, Rowan</creator><creatorcontrib>Aw, Darren ; Woodrow, Lauren ; Ogliari, Giulia ; Harwood, Rowan</creatorcontrib><description>Abstract
Background
COVID-19 has disproportionately affected older people.
Objective
The objective of this paper to investigate whether frailty is associated with all-cause mortality in older hospital inpatients, with COVID-19.
Design
Cohort study.
Setting
Secondary care acute hospital.
Participants
Participants included are 677 consecutive inpatients aged 65 years and over.
Methods
Cox proportional hazards models were used to examine the association of frailty with mortality. Frailty was assessed at baseline, according to the Clinical Frailty Scale (CFS), where higher categories indicate worse frailty. Analyses were adjusted for age, sex, deprivation, ethnicity, previous admissions and acute illness severity.
Results
Six hundred and sixty-four patients were classified according to CFS. Two hundred and seventy-one died, during a mean follow-up of 34.3 days. Worse frailty at baseline was associated with increased mortality risk, even after full adjustment (P = 0.004). Patients with CFS 4 and CFS 5 had non-significant increased mortality risks, compared to those with CFS 1–3. Patients with CFS 6 had a 2.13-fold (95% CI 1.34–3.38) and those with CFS 7–9 had a 1.79-fold (95% CI 1.12–2.88) increased mortality risk, compared to those with CFS 1–3 (P = 0.001 and 0.016, respectively). Older age, male sex and acute illness severity were also associated with increased mortality risk.
Conclusions
Frailty is associated with all-cause mortality risk in older inpatients with COVID-19.</description><identifier>ISSN: 0002-0729</identifier><identifier>EISSN: 1468-2834</identifier><identifier>DOI: 10.1093/ageing/afaa184</identifier><identifier>PMID: 32778870</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><subject>Aged ; Aged, 80 and over ; Betacoronavirus ; Cohort analysis ; Coronavirus Infections - mortality ; Coronaviruses ; COVID-19 ; Deprivation ; Ethnicity ; Female ; Frail Elderly - statistics & numerical data ; Frailty ; Frailty - epidemiology ; Geriatric Assessment - methods ; Hospital Mortality - trends ; Hospitalization ; Humans ; Inpatients - statistics & numerical data ; Longitudinal studies ; Male ; Mortality ; Older people ; Pandemics ; Patients ; Pneumonia, Viral - mortality ; Research Paper ; SARS-CoV-2 ; Survival Rate - trends ; United Kingdom - epidemiology</subject><ispartof>Age and ageing, 2020-11, Vol.49 (6), p.915-922</ispartof><rights>The Author(s) 2020. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: journals.permissions@oup.com 2020</rights><rights>The Author(s) 2020. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.</rights><rights>The Author(s) 2020. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: journals.permissions@oup.com</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c452t-aa6765c3d8e7078a1e1121a6d82562b7caee5fc748a983f6fe825fdf2c8f5b4f3</citedby><cites>FETCH-LOGICAL-c452t-aa6765c3d8e7078a1e1121a6d82562b7caee5fc748a983f6fe825fdf2c8f5b4f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,1578,27901,27902,30976</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32778870$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Aw, Darren</creatorcontrib><creatorcontrib>Woodrow, Lauren</creatorcontrib><creatorcontrib>Ogliari, Giulia</creatorcontrib><creatorcontrib>Harwood, Rowan</creatorcontrib><title>Association of frailty with mortality in older inpatients with Covid-19: a cohort study</title><title>Age and ageing</title><addtitle>Age Ageing</addtitle><description>Abstract
Background
COVID-19 has disproportionately affected older people.
Objective
The objective of this paper to investigate whether frailty is associated with all-cause mortality in older hospital inpatients, with COVID-19.
Design
Cohort study.
Setting
Secondary care acute hospital.
Participants
Participants included are 677 consecutive inpatients aged 65 years and over.
Methods
Cox proportional hazards models were used to examine the association of frailty with mortality. Frailty was assessed at baseline, according to the Clinical Frailty Scale (CFS), where higher categories indicate worse frailty. Analyses were adjusted for age, sex, deprivation, ethnicity, previous admissions and acute illness severity.
Results
Six hundred and sixty-four patients were classified according to CFS. Two hundred and seventy-one died, during a mean follow-up of 34.3 days. Worse frailty at baseline was associated with increased mortality risk, even after full adjustment (P = 0.004). Patients with CFS 4 and CFS 5 had non-significant increased mortality risks, compared to those with CFS 1–3. Patients with CFS 6 had a 2.13-fold (95% CI 1.34–3.38) and those with CFS 7–9 had a 1.79-fold (95% CI 1.12–2.88) increased mortality risk, compared to those with CFS 1–3 (P = 0.001 and 0.016, respectively). Older age, male sex and acute illness severity were also associated with increased mortality risk.
Conclusions
Frailty is associated with all-cause mortality risk in older inpatients with COVID-19.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Betacoronavirus</subject><subject>Cohort analysis</subject><subject>Coronavirus Infections - mortality</subject><subject>Coronaviruses</subject><subject>COVID-19</subject><subject>Deprivation</subject><subject>Ethnicity</subject><subject>Female</subject><subject>Frail Elderly - statistics & numerical data</subject><subject>Frailty</subject><subject>Frailty - epidemiology</subject><subject>Geriatric Assessment - methods</subject><subject>Hospital Mortality - trends</subject><subject>Hospitalization</subject><subject>Humans</subject><subject>Inpatients - statistics & numerical data</subject><subject>Longitudinal studies</subject><subject>Male</subject><subject>Mortality</subject><subject>Older people</subject><subject>Pandemics</subject><subject>Patients</subject><subject>Pneumonia, Viral - mortality</subject><subject>Research Paper</subject><subject>SARS-CoV-2</subject><subject>Survival Rate - trends</subject><subject>United Kingdom - epidemiology</subject><issn>0002-0729</issn><issn>1468-2834</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><recordid>eNqFkUtLxDAUhYMoOj62LqXgRhfVJE2a1IUwDL5AcKO4DHfSZCbSacakVebfG-ko6sZVcjnfPZzLQeiQ4DOCq-IcZsa1s3OwAESyDTQirJQ5lQXbRCOMMc2xoNUO2o3xJY2EE7qNdgoqhJQCj9DzOEavHXTOt5m3mQ3gmm6Vvbtuni186KBxaXRJbGoT0meZWNN2cUAm_s3VOakuMsi0n6eFLHZ9vdpHWxaaaA7W7x56ur56nNzm9w83d5Pxfa4Zp10OUIqS66KWRmAhgRhCKIGylpSXdCo0GMOtFkxCJQtbWpMEW1uqpeVTZos9dDn4LvvpwtQ6JQvQqGVwCwgr5cGp30rr5mrm35RgnFHOksHJ2iD4197ETi1c1KZpoDW-j4qygkrOJKEJPf6Dvvg-tOm8RIkyJZfVp-HZQOngYwzGfochWH12pobO1LqztHD084Rv_KukBJwOgO-X_5l9AGXvpAs</recordid><startdate>20201101</startdate><enddate>20201101</enddate><creator>Aw, Darren</creator><creator>Woodrow, Lauren</creator><creator>Ogliari, Giulia</creator><creator>Harwood, Rowan</creator><general>Oxford University Press</general><general>Oxford Publishing Limited (England)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QJ</scope><scope>7T5</scope><scope>7TK</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20201101</creationdate><title>Association of frailty with mortality in older inpatients with Covid-19: a cohort study</title><author>Aw, Darren ; Woodrow, Lauren ; Ogliari, Giulia ; Harwood, Rowan</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c452t-aa6765c3d8e7078a1e1121a6d82562b7caee5fc748a983f6fe825fdf2c8f5b4f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Betacoronavirus</topic><topic>Cohort analysis</topic><topic>Coronavirus Infections - mortality</topic><topic>Coronaviruses</topic><topic>COVID-19</topic><topic>Deprivation</topic><topic>Ethnicity</topic><topic>Female</topic><topic>Frail Elderly - statistics & numerical data</topic><topic>Frailty</topic><topic>Frailty - epidemiology</topic><topic>Geriatric Assessment - methods</topic><topic>Hospital Mortality - trends</topic><topic>Hospitalization</topic><topic>Humans</topic><topic>Inpatients - statistics & numerical data</topic><topic>Longitudinal studies</topic><topic>Male</topic><topic>Mortality</topic><topic>Older people</topic><topic>Pandemics</topic><topic>Patients</topic><topic>Pneumonia, Viral - mortality</topic><topic>Research Paper</topic><topic>SARS-CoV-2</topic><topic>Survival Rate - trends</topic><topic>United Kingdom - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Aw, Darren</creatorcontrib><creatorcontrib>Woodrow, Lauren</creatorcontrib><creatorcontrib>Ogliari, Giulia</creatorcontrib><creatorcontrib>Harwood, Rowan</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Age and ageing</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Aw, Darren</au><au>Woodrow, Lauren</au><au>Ogliari, Giulia</au><au>Harwood, Rowan</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Association of frailty with mortality in older inpatients with Covid-19: a cohort study</atitle><jtitle>Age and ageing</jtitle><addtitle>Age Ageing</addtitle><date>2020-11-01</date><risdate>2020</risdate><volume>49</volume><issue>6</issue><spage>915</spage><epage>922</epage><pages>915-922</pages><issn>0002-0729</issn><eissn>1468-2834</eissn><abstract>Abstract
Background
COVID-19 has disproportionately affected older people.
Objective
The objective of this paper to investigate whether frailty is associated with all-cause mortality in older hospital inpatients, with COVID-19.
Design
Cohort study.
Setting
Secondary care acute hospital.
Participants
Participants included are 677 consecutive inpatients aged 65 years and over.
Methods
Cox proportional hazards models were used to examine the association of frailty with mortality. Frailty was assessed at baseline, according to the Clinical Frailty Scale (CFS), where higher categories indicate worse frailty. Analyses were adjusted for age, sex, deprivation, ethnicity, previous admissions and acute illness severity.
Results
Six hundred and sixty-four patients were classified according to CFS. Two hundred and seventy-one died, during a mean follow-up of 34.3 days. Worse frailty at baseline was associated with increased mortality risk, even after full adjustment (P = 0.004). Patients with CFS 4 and CFS 5 had non-significant increased mortality risks, compared to those with CFS 1–3. Patients with CFS 6 had a 2.13-fold (95% CI 1.34–3.38) and those with CFS 7–9 had a 1.79-fold (95% CI 1.12–2.88) increased mortality risk, compared to those with CFS 1–3 (P = 0.001 and 0.016, respectively). Older age, male sex and acute illness severity were also associated with increased mortality risk.
Conclusions
Frailty is associated with all-cause mortality risk in older inpatients with COVID-19.</abstract><cop>England</cop><pub>Oxford University Press</pub><pmid>32778870</pmid><doi>10.1093/ageing/afaa184</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0002-0729 |
| ispartof | Age and ageing, 2020-11, Vol.49 (6), p.915-922 |
| issn | 0002-0729 1468-2834 |
| language | eng |
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| source | Applied Social Sciences Index & Abstracts (ASSIA); Oxford University Press Journals All Titles (1996-Current); MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection |
| subjects | Aged Aged, 80 and over Betacoronavirus Cohort analysis Coronavirus Infections - mortality Coronaviruses COVID-19 Deprivation Ethnicity Female Frail Elderly - statistics & numerical data Frailty Frailty - epidemiology Geriatric Assessment - methods Hospital Mortality - trends Hospitalization Humans Inpatients - statistics & numerical data Longitudinal studies Male Mortality Older people Pandemics Patients Pneumonia, Viral - mortality Research Paper SARS-CoV-2 Survival Rate - trends United Kingdom - epidemiology |
| title | Association of frailty with mortality in older inpatients with Covid-19: a cohort study |
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