TY - JOUR
T1 - Frailty is associated with in-hospital mortality in older hospitalised COVID-19 patients in the Netherlands
T2 - the COVID-OLD study
AU - Blomaard, Laura C.
AU - van der Linden, Carolien M.J.
AU - van der Bol, Jessica M.
AU - Jansen, Steffy W.M.
AU - Polinder-Bos, Harmke A.
AU - Willems, Hanna C.
AU - Festen, Jan
AU - Barten, Dennis G.
AU - Borgers, Anke J.
AU - Bos, Jeannet C.
AU - van den Bos, Frederiek
AU - de Brouwer, Esther J.M.
AU - van Deudekom, Floor J.A.
AU - van Dijk, Suzanne C.
AU - Emmelot-Vonk, Mariëlle H.
AU - Geels, Raya E.S.
AU - van de Glind, Esther M.M.
AU - de Groot, Bas
AU - Hempenius, Liesbeth
AU - Kamper, Ad M.
AU - Kampschreur, Linda M.
AU - de Koning, Marre M.M.
AU - Labots, Geert
AU - Looman, Roy
AU - Lucke, Jacinta A.
AU - Maas, Huub A.A.M.
AU - Mattace-Raso, Francesco U.S.
AU - El Moussaoui, Rachida
AU - van Munster, Barbara C.
AU - van Nieuwkoop, Cees
AU - Oosterwijk, Leanne B.L.E.
AU - Regtuijt, Marlies E.M.
AU - Robben, Sarah H.M.
AU - Ruiter, Rikje
AU - Salarbaks, Aisha M.
AU - Schouten, Henrike J.
AU - Smit, Orla M.
AU - Smits, Rosalinde A.L.
AU - Spies, Petra E.
AU - Vreeswijk, Ralph
AU - de Vries, Oscar J.
AU - Wijngaarden, Marjolein A.
AU - Wyers, Caroline E.
AU - Mooijaart, Simon P.
N1 - Publisher Copyright:
© The Author(s) 2021. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.
PY - 2021/5/5
Y1 - 2021/5/5
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=85101423559&partnerID=8YFLogxK
U2 - 10.1093/ageing/afab018
DO - 10.1093/ageing/afab018
M3 - Article
C2 - 33951156
AN - SCOPUS:85101423559
SN - 0002-0729
VL - 50
SP - 631
EP - 640
JO - Age and Ageing
JF - Age and Ageing
IS - 3
ER -