Predictors of In-Hospital Mortality in Older Patients With COVID-19: The COVIDAge Study
To determine predictors of in-hospital mortality related to COVID-19 in older patients. Retrospective cohort study. Patients aged 65 years and older hospitalized for a diagnosis of COVID-19. Data from hospital admission were collected from the electronic medical records. Logistic regression and Cox...
Gespeichert in:
| Veröffentlicht in: | Journal of the American Medical Directors Association 2020-11, Vol.21 (11), p.1546-1554.e3 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 1554.e3 |
|---|---|
| container_issue | 11 |
| container_start_page | 1546 |
| container_title | Journal of the American Medical Directors Association |
| container_volume | 21 |
| creator | Mendes, Aline Serratrice, Christine Herrmann, François R. Genton, Laurence Périvier, Samuel Scheffler, Max Fassier, Thomas Huber, Philippe Jacques, Marie-Claire Prendki, Virginie Roux, Xavier Di Silvestro, Katharine Trombert, Véronique Harbarth, Stephan Gold, Gabriel Graf, Christophe E. Zekry, Dina |
| description | To determine predictors of in-hospital mortality related to COVID-19 in older patients.
Retrospective cohort study.
Patients aged 65 years and older hospitalized for a diagnosis of COVID-19.
Data from hospital admission were collected from the electronic medical records. Logistic regression and Cox proportional hazard models were used to predict mortality, our primary outcome. Variables at hospital admission were categorized according to the following domains: demographics, clinical history, comorbidities, previous treatment, clinical status, vital signs, clinical scales and scores, routine laboratory analysis, and imaging results.
Of a total of 235 Caucasian patients, 43% were male, with a mean age of 86 ± 6.5 years. Seventy-six patients (32%) died. Nonsurvivors had a shorter number of days from initial symptoms to hospitalization (P = .007) and the length of stay in acute wards than survivors (P |
| doi_str_mv | 10.1016/j.jamda.2020.09.014 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7491997</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S1525861020307970</els_id><sourcerecordid>2457303898</sourcerecordid><originalsourceid>FETCH-LOGICAL-c459t-754b293b1ac596faf469cedca9af802241445b264209ad252b5ed1869fe2a1593</originalsourceid><addsrcrecordid>eNp9UV1PGzEQtFARUNpfgIT82Je7-vPuthJIKNASCRSk0vJo-Xw-4uhyDraDlH9fp6GovPC0u9qZ2dUMQieUlJTQ6uuiXOhlp0tGGCkJlISKPXREJW8K4LX8sO2ZLJqKkkP0McYFyUAK1QE65JzyBnh1hB7ugu2cST5E7Hs8HYtrH1cu6QHf-pCLSxvsRjwbOhvwnU7OjiniB5fmeDL7Pb0sKHzD93O7my4eLf6Z1t3mE9rv9RDt55d6jH59v7qfXBc3sx_TycVNYYSEVNRStAx4S7WRUPW6FxUY2xkNum8IY4IKIVtWCUZAd0yyVtqONhX0lmkqgR-j853uat0uMzF_F_SgVsEtddgor516uxndXD36Z1ULoAB1FvjyIhD809rGpJYuGjsMerR-HRUTsuYku9VkKN9BTfAxBtu_nqFEbSNRC_U3ErWNRBFQOZLMOv3_w1fOvwwy4GwHsNmnZ2eDiia7nG1wwZqkOu_ePfAHRGCc6w</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2457303898</pqid></control><display><type>article</type><title>Predictors of In-Hospital Mortality in Older Patients With COVID-19: The COVIDAge Study</title><source>MEDLINE</source><source>Access via ScienceDirect (Elsevier)</source><creator>Mendes, Aline ; Serratrice, Christine ; Herrmann, François R. ; Genton, Laurence ; Périvier, Samuel ; Scheffler, Max ; Fassier, Thomas ; Huber, Philippe ; Jacques, Marie-Claire ; Prendki, Virginie ; Roux, Xavier ; Di Silvestro, Katharine ; Trombert, Véronique ; Harbarth, Stephan ; Gold, Gabriel ; Graf, Christophe E. ; Zekry, Dina</creator><creatorcontrib>Mendes, Aline ; Serratrice, Christine ; Herrmann, François R. ; Genton, Laurence ; Périvier, Samuel ; Scheffler, Max ; Fassier, Thomas ; Huber, Philippe ; Jacques, Marie-Claire ; Prendki, Virginie ; Roux, Xavier ; Di Silvestro, Katharine ; Trombert, Véronique ; Harbarth, Stephan ; Gold, Gabriel ; Graf, Christophe E. ; Zekry, Dina</creatorcontrib><description><![CDATA[To determine predictors of in-hospital mortality related to COVID-19 in older patients.
Retrospective cohort study.
Patients aged 65 years and older hospitalized for a diagnosis of COVID-19.
Data from hospital admission were collected from the electronic medical records. Logistic regression and Cox proportional hazard models were used to predict mortality, our primary outcome. Variables at hospital admission were categorized according to the following domains: demographics, clinical history, comorbidities, previous treatment, clinical status, vital signs, clinical scales and scores, routine laboratory analysis, and imaging results.
Of a total of 235 Caucasian patients, 43% were male, with a mean age of 86 ± 6.5 years. Seventy-six patients (32%) died. Nonsurvivors had a shorter number of days from initial symptoms to hospitalization (P = .007) and the length of stay in acute wards than survivors (P < .001). Similarly, they had a higher prevalence of heart failure (P = .044), peripheral artery disease (P = .009), crackles at clinical status (P < .001), respiratory rate (P = .005), oxygen support needs (P < .001), C-reactive protein (P < .001), bilateral and peripheral infiltrates on chest radiographs (P = .001), and a lower prevalence of headache (P = .009). Furthermore, nonsurvivors were more often frail (P < .001), with worse functional status (P < .001), higher comorbidity burden (P < .001), and delirium at admission (P = .007). A multivariable Cox model showed that male sex (HR 4.00, 95% CI 2.08-7.71, P < .001), increased fraction of inspired oxygen (HR 1.06, 95% CI 1.03-1.09, P < .001), and crackles (HR 2.42, 95% CI 1.15-6.06, P = .019) were the best predictors of mortality, while better functional status was protective (HR 0.98, 95% CI 0.97-0.99, P = .001).
In older patients hospitalized for COVID-19, male sex, crackles, a higher fraction of inspired oxygen, and functionality were independent risk factors of mortality. These routine parameters, and not differences in age, should be used to evaluate prognosis in older patients.]]></description><identifier>ISSN: 1525-8610</identifier><identifier>EISSN: 1538-9375</identifier><identifier>DOI: 10.1016/j.jamda.2020.09.014</identifier><identifier>PMID: 33138936</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Aged ; Aged, 80 and over ; Betacoronavirus ; Comorbidity ; Coronavirus Infections - mortality ; COVID-19 ; Female ; Forecasting ; Geriatrics ; Hospital Mortality - trends ; Humans ; Male ; Mortality ; older patients ; Pandemics ; Pneumonia, Viral - mortality ; Prognosis ; Proportional Hazards Models ; Retrospective Studies ; SARS-CoV-2</subject><ispartof>Journal of the American Medical Directors Association, 2020-11, Vol.21 (11), p.1546-1554.e3</ispartof><rights>2020 AMDA – The Society for Post-Acute and Long-Term Care Medicine</rights><rights>Copyright © 2020 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.</rights><rights>2020 AMDA - The Society for Post-Acute and Long-Term Care Medicine. 2020 AMDA – The Society for Post-Acute and Long-Term Care Medicine</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c459t-754b293b1ac596faf469cedca9af802241445b264209ad252b5ed1869fe2a1593</citedby><cites>FETCH-LOGICAL-c459t-754b293b1ac596faf469cedca9af802241445b264209ad252b5ed1869fe2a1593</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jamda.2020.09.014$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,780,784,885,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33138936$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mendes, Aline</creatorcontrib><creatorcontrib>Serratrice, Christine</creatorcontrib><creatorcontrib>Herrmann, François R.</creatorcontrib><creatorcontrib>Genton, Laurence</creatorcontrib><creatorcontrib>Périvier, Samuel</creatorcontrib><creatorcontrib>Scheffler, Max</creatorcontrib><creatorcontrib>Fassier, Thomas</creatorcontrib><creatorcontrib>Huber, Philippe</creatorcontrib><creatorcontrib>Jacques, Marie-Claire</creatorcontrib><creatorcontrib>Prendki, Virginie</creatorcontrib><creatorcontrib>Roux, Xavier</creatorcontrib><creatorcontrib>Di Silvestro, Katharine</creatorcontrib><creatorcontrib>Trombert, Véronique</creatorcontrib><creatorcontrib>Harbarth, Stephan</creatorcontrib><creatorcontrib>Gold, Gabriel</creatorcontrib><creatorcontrib>Graf, Christophe E.</creatorcontrib><creatorcontrib>Zekry, Dina</creatorcontrib><title>Predictors of In-Hospital Mortality in Older Patients With COVID-19: The COVIDAge Study</title><title>Journal of the American Medical Directors Association</title><addtitle>J Am Med Dir Assoc</addtitle><description><![CDATA[To determine predictors of in-hospital mortality related to COVID-19 in older patients.
Retrospective cohort study.
Patients aged 65 years and older hospitalized for a diagnosis of COVID-19.
Data from hospital admission were collected from the electronic medical records. Logistic regression and Cox proportional hazard models were used to predict mortality, our primary outcome. Variables at hospital admission were categorized according to the following domains: demographics, clinical history, comorbidities, previous treatment, clinical status, vital signs, clinical scales and scores, routine laboratory analysis, and imaging results.
Of a total of 235 Caucasian patients, 43% were male, with a mean age of 86 ± 6.5 years. Seventy-six patients (32%) died. Nonsurvivors had a shorter number of days from initial symptoms to hospitalization (P = .007) and the length of stay in acute wards than survivors (P < .001). Similarly, they had a higher prevalence of heart failure (P = .044), peripheral artery disease (P = .009), crackles at clinical status (P < .001), respiratory rate (P = .005), oxygen support needs (P < .001), C-reactive protein (P < .001), bilateral and peripheral infiltrates on chest radiographs (P = .001), and a lower prevalence of headache (P = .009). Furthermore, nonsurvivors were more often frail (P < .001), with worse functional status (P < .001), higher comorbidity burden (P < .001), and delirium at admission (P = .007). A multivariable Cox model showed that male sex (HR 4.00, 95% CI 2.08-7.71, P < .001), increased fraction of inspired oxygen (HR 1.06, 95% CI 1.03-1.09, P < .001), and crackles (HR 2.42, 95% CI 1.15-6.06, P = .019) were the best predictors of mortality, while better functional status was protective (HR 0.98, 95% CI 0.97-0.99, P = .001).
In older patients hospitalized for COVID-19, male sex, crackles, a higher fraction of inspired oxygen, and functionality were independent risk factors of mortality. These routine parameters, and not differences in age, should be used to evaluate prognosis in older patients.]]></description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Betacoronavirus</subject><subject>Comorbidity</subject><subject>Coronavirus Infections - mortality</subject><subject>COVID-19</subject><subject>Female</subject><subject>Forecasting</subject><subject>Geriatrics</subject><subject>Hospital Mortality - trends</subject><subject>Humans</subject><subject>Male</subject><subject>Mortality</subject><subject>older patients</subject><subject>Pandemics</subject><subject>Pneumonia, Viral - mortality</subject><subject>Prognosis</subject><subject>Proportional Hazards Models</subject><subject>Retrospective Studies</subject><subject>SARS-CoV-2</subject><issn>1525-8610</issn><issn>1538-9375</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9UV1PGzEQtFARUNpfgIT82Je7-vPuthJIKNASCRSk0vJo-Xw-4uhyDraDlH9fp6GovPC0u9qZ2dUMQieUlJTQ6uuiXOhlp0tGGCkJlISKPXREJW8K4LX8sO2ZLJqKkkP0McYFyUAK1QE65JzyBnh1hB7ugu2cST5E7Hs8HYtrH1cu6QHf-pCLSxvsRjwbOhvwnU7OjiniB5fmeDL7Pb0sKHzD93O7my4eLf6Z1t3mE9rv9RDt55d6jH59v7qfXBc3sx_TycVNYYSEVNRStAx4S7WRUPW6FxUY2xkNum8IY4IKIVtWCUZAd0yyVtqONhX0lmkqgR-j853uat0uMzF_F_SgVsEtddgor516uxndXD36Z1ULoAB1FvjyIhD809rGpJYuGjsMerR-HRUTsuYku9VkKN9BTfAxBtu_nqFEbSNRC_U3ErWNRBFQOZLMOv3_w1fOvwwy4GwHsNmnZ2eDiia7nG1wwZqkOu_ePfAHRGCc6w</recordid><startdate>20201101</startdate><enddate>20201101</enddate><creator>Mendes, Aline</creator><creator>Serratrice, Christine</creator><creator>Herrmann, François R.</creator><creator>Genton, Laurence</creator><creator>Périvier, Samuel</creator><creator>Scheffler, Max</creator><creator>Fassier, Thomas</creator><creator>Huber, Philippe</creator><creator>Jacques, Marie-Claire</creator><creator>Prendki, Virginie</creator><creator>Roux, Xavier</creator><creator>Di Silvestro, Katharine</creator><creator>Trombert, Véronique</creator><creator>Harbarth, Stephan</creator><creator>Gold, Gabriel</creator><creator>Graf, Christophe E.</creator><creator>Zekry, Dina</creator><general>Elsevier Inc</general><general>AMDA - The Society for Post-Acute and Long-Term Care Medicine</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>7X8</scope><scope>5PM</scope></search><sort><creationdate>20201101</creationdate><title>Predictors of In-Hospital Mortality in Older Patients With COVID-19: The COVIDAge Study</title><author>Mendes, Aline ; Serratrice, Christine ; Herrmann, François R. ; Genton, Laurence ; Périvier, Samuel ; Scheffler, Max ; Fassier, Thomas ; Huber, Philippe ; Jacques, Marie-Claire ; Prendki, Virginie ; Roux, Xavier ; Di Silvestro, Katharine ; Trombert, Véronique ; Harbarth, Stephan ; Gold, Gabriel ; Graf, Christophe E. ; Zekry, Dina</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c459t-754b293b1ac596faf469cedca9af802241445b264209ad252b5ed1869fe2a1593</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>Comorbidity</topic><topic>Coronavirus Infections - mortality</topic><topic>COVID-19</topic><topic>Female</topic><topic>Forecasting</topic><topic>Geriatrics</topic><topic>Hospital Mortality - trends</topic><topic>Humans</topic><topic>Male</topic><topic>Mortality</topic><topic>older patients</topic><topic>Pandemics</topic><topic>Pneumonia, Viral - mortality</topic><topic>Prognosis</topic><topic>Proportional Hazards Models</topic><topic>Retrospective Studies</topic><topic>SARS-CoV-2</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mendes, Aline</creatorcontrib><creatorcontrib>Serratrice, Christine</creatorcontrib><creatorcontrib>Herrmann, François R.</creatorcontrib><creatorcontrib>Genton, Laurence</creatorcontrib><creatorcontrib>Périvier, Samuel</creatorcontrib><creatorcontrib>Scheffler, Max</creatorcontrib><creatorcontrib>Fassier, Thomas</creatorcontrib><creatorcontrib>Huber, Philippe</creatorcontrib><creatorcontrib>Jacques, Marie-Claire</creatorcontrib><creatorcontrib>Prendki, Virginie</creatorcontrib><creatorcontrib>Roux, Xavier</creatorcontrib><creatorcontrib>Di Silvestro, Katharine</creatorcontrib><creatorcontrib>Trombert, Véronique</creatorcontrib><creatorcontrib>Harbarth, Stephan</creatorcontrib><creatorcontrib>Gold, Gabriel</creatorcontrib><creatorcontrib>Graf, Christophe E.</creatorcontrib><creatorcontrib>Zekry, Dina</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of the American Medical Directors Association</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mendes, Aline</au><au>Serratrice, Christine</au><au>Herrmann, François R.</au><au>Genton, Laurence</au><au>Périvier, Samuel</au><au>Scheffler, Max</au><au>Fassier, Thomas</au><au>Huber, Philippe</au><au>Jacques, Marie-Claire</au><au>Prendki, Virginie</au><au>Roux, Xavier</au><au>Di Silvestro, Katharine</au><au>Trombert, Véronique</au><au>Harbarth, Stephan</au><au>Gold, Gabriel</au><au>Graf, Christophe E.</au><au>Zekry, Dina</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Predictors of In-Hospital Mortality in Older Patients With COVID-19: The COVIDAge Study</atitle><jtitle>Journal of the American Medical Directors Association</jtitle><addtitle>J Am Med Dir Assoc</addtitle><date>2020-11-01</date><risdate>2020</risdate><volume>21</volume><issue>11</issue><spage>1546</spage><epage>1554.e3</epage><pages>1546-1554.e3</pages><issn>1525-8610</issn><eissn>1538-9375</eissn><abstract><![CDATA[To determine predictors of in-hospital mortality related to COVID-19 in older patients.
Retrospective cohort study.
Patients aged 65 years and older hospitalized for a diagnosis of COVID-19.
Data from hospital admission were collected from the electronic medical records. Logistic regression and Cox proportional hazard models were used to predict mortality, our primary outcome. Variables at hospital admission were categorized according to the following domains: demographics, clinical history, comorbidities, previous treatment, clinical status, vital signs, clinical scales and scores, routine laboratory analysis, and imaging results.
Of a total of 235 Caucasian patients, 43% were male, with a mean age of 86 ± 6.5 years. Seventy-six patients (32%) died. Nonsurvivors had a shorter number of days from initial symptoms to hospitalization (P = .007) and the length of stay in acute wards than survivors (P < .001). Similarly, they had a higher prevalence of heart failure (P = .044), peripheral artery disease (P = .009), crackles at clinical status (P < .001), respiratory rate (P = .005), oxygen support needs (P < .001), C-reactive protein (P < .001), bilateral and peripheral infiltrates on chest radiographs (P = .001), and a lower prevalence of headache (P = .009). Furthermore, nonsurvivors were more often frail (P < .001), with worse functional status (P < .001), higher comorbidity burden (P < .001), and delirium at admission (P = .007). A multivariable Cox model showed that male sex (HR 4.00, 95% CI 2.08-7.71, P < .001), increased fraction of inspired oxygen (HR 1.06, 95% CI 1.03-1.09, P < .001), and crackles (HR 2.42, 95% CI 1.15-6.06, P = .019) were the best predictors of mortality, while better functional status was protective (HR 0.98, 95% CI 0.97-0.99, P = .001).
In older patients hospitalized for COVID-19, male sex, crackles, a higher fraction of inspired oxygen, and functionality were independent risk factors of mortality. These routine parameters, and not differences in age, should be used to evaluate prognosis in older patients.]]></abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>33138936</pmid><doi>10.1016/j.jamda.2020.09.014</doi><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1525-8610 |
| ispartof | Journal of the American Medical Directors Association, 2020-11, Vol.21 (11), p.1546-1554.e3 |
| issn | 1525-8610 1538-9375 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7491997 |
| source | MEDLINE; Access via ScienceDirect (Elsevier) |
| subjects | Aged Aged, 80 and over Betacoronavirus Comorbidity Coronavirus Infections - mortality COVID-19 Female Forecasting Geriatrics Hospital Mortality - trends Humans Male Mortality older patients Pandemics Pneumonia, Viral - mortality Prognosis Proportional Hazards Models Retrospective Studies SARS-CoV-2 |
| title | Predictors of In-Hospital Mortality in Older Patients With COVID-19: The COVIDAge Study |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-24T20%3A20%3A36IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Predictors%20of%20In-Hospital%20Mortality%20in%20Older%20Patients%20With%20COVID-19:%20The%20COVIDAge%20Study&rft.jtitle=Journal%20of%20the%20American%20Medical%20Directors%20Association&rft.au=Mendes,%20Aline&rft.date=2020-11-01&rft.volume=21&rft.issue=11&rft.spage=1546&rft.epage=1554.e3&rft.pages=1546-1554.e3&rft.issn=1525-8610&rft.eissn=1538-9375&rft_id=info:doi/10.1016/j.jamda.2020.09.014&rft_dat=%3Cproquest_pubme%3E2457303898%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2457303898&rft_id=info:pmid/33138936&rft_els_id=S1525861020307970&rfr_iscdi=true |