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Individual and contextual risk factors for mortality in nursing home residents during the first wave of COVID-19 in France: a multilevel analysis of a nationwide cohort study

BACKGROUND: Mortality amongst nursing home (NH) residents increased by 43% during the first wave of coronavirus disease 2019 (COVID-19). We estimated the ‘contextual effect’ on mortality, tried to explain it by NH characteristics and identified resident- and NH-level risk factors for mortality. METH...

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Autores principales: Rachas, Antoine, Fontaine, Roméo, Thomas, Martine, Robine, Jean-Marie, Gavazzi, Gaëtan, Laurent, Marie, Carcaillon-Bentata, Laure, Canouï-Poitrine, Florence
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10471198/
https://www.ncbi.nlm.nih.gov/pubmed/37651749
http://dx.doi.org/10.1093/ageing/afad165
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author Rachas, Antoine
Fontaine, Roméo
Thomas, Martine
Robine, Jean-Marie
Gavazzi, Gaëtan
Laurent, Marie
Carcaillon-Bentata, Laure
Canouï-Poitrine, Florence
author_facet Rachas, Antoine
Fontaine, Roméo
Thomas, Martine
Robine, Jean-Marie
Gavazzi, Gaëtan
Laurent, Marie
Carcaillon-Bentata, Laure
Canouï-Poitrine, Florence
author_sort Rachas, Antoine
collection PubMed
description BACKGROUND: Mortality amongst nursing home (NH) residents increased by 43% during the first wave of coronavirus disease 2019 (COVID-19). We estimated the ‘contextual effect’ on mortality, tried to explain it by NH characteristics and identified resident- and NH-level risk factors for mortality. METHODS: The contextual effect was measured for two cohorts of NH residents managed by the general scheme in metropolitan France (RESIDESMS data from 03/01/2020 to 05/31/2020 and 03/01/2019 to 05/31/2019) by the intraclass correlation coefficient (ICC) estimated from mixed-effects logistic regression. RESULTS: Amongst 385,300 residents (5,339 NHs) included in 2020 (median age 89 years, 25% men), 9.1% died, versus 6.7% of 379,926 residents (5,270 NHs) in 2019. In the empty model, the ICC was 9.3% in 2020 and 1.5% in 2019. Only the geographic location partially explained the heterogeneity observed in 2020 (ICC: 6.5% after adjustment). Associations with mortality were stronger in 2020 than in 2019 for male sex and diabetes and weaker for heart disease, chronic respiratory disease and residence <6 months. Mortality was higher in 2020 (15.1%) than 2019 (6.3%) in NHs with at least one death with a mention of COVID-19 and more heterogeneous (ICC: 8.0%) than in the others (mortality: 6.7% in both years; ICC: 1.1%). CONCLUSION: Our results suggest that the COVID-19 crisis had a heterogeneous impact on mortality in NH residents and that geographic location explain a part of the contextual effect, which appears to have had little influence on mortality in NHs not being affected by the virus.
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spelling pubmed-104711982023-09-01 Individual and contextual risk factors for mortality in nursing home residents during the first wave of COVID-19 in France: a multilevel analysis of a nationwide cohort study Rachas, Antoine Fontaine, Roméo Thomas, Martine Robine, Jean-Marie Gavazzi, Gaëtan Laurent, Marie Carcaillon-Bentata, Laure Canouï-Poitrine, Florence Age Ageing Research Paper BACKGROUND: Mortality amongst nursing home (NH) residents increased by 43% during the first wave of coronavirus disease 2019 (COVID-19). We estimated the ‘contextual effect’ on mortality, tried to explain it by NH characteristics and identified resident- and NH-level risk factors for mortality. METHODS: The contextual effect was measured for two cohorts of NH residents managed by the general scheme in metropolitan France (RESIDESMS data from 03/01/2020 to 05/31/2020 and 03/01/2019 to 05/31/2019) by the intraclass correlation coefficient (ICC) estimated from mixed-effects logistic regression. RESULTS: Amongst 385,300 residents (5,339 NHs) included in 2020 (median age 89 years, 25% men), 9.1% died, versus 6.7% of 379,926 residents (5,270 NHs) in 2019. In the empty model, the ICC was 9.3% in 2020 and 1.5% in 2019. Only the geographic location partially explained the heterogeneity observed in 2020 (ICC: 6.5% after adjustment). Associations with mortality were stronger in 2020 than in 2019 for male sex and diabetes and weaker for heart disease, chronic respiratory disease and residence <6 months. Mortality was higher in 2020 (15.1%) than 2019 (6.3%) in NHs with at least one death with a mention of COVID-19 and more heterogeneous (ICC: 8.0%) than in the others (mortality: 6.7% in both years; ICC: 1.1%). CONCLUSION: Our results suggest that the COVID-19 crisis had a heterogeneous impact on mortality in NH residents and that geographic location explain a part of the contextual effect, which appears to have had little influence on mortality in NHs not being affected by the virus. Oxford University Press 2023-08-30 /pmc/articles/PMC10471198/ /pubmed/37651749 http://dx.doi.org/10.1093/ageing/afad165 Text en © The Author(s) 2023. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: journals.permissions@oup.com https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Research Paper
Rachas, Antoine
Fontaine, Roméo
Thomas, Martine
Robine, Jean-Marie
Gavazzi, Gaëtan
Laurent, Marie
Carcaillon-Bentata, Laure
Canouï-Poitrine, Florence
Individual and contextual risk factors for mortality in nursing home residents during the first wave of COVID-19 in France: a multilevel analysis of a nationwide cohort study
title Individual and contextual risk factors for mortality in nursing home residents during the first wave of COVID-19 in France: a multilevel analysis of a nationwide cohort study
title_full Individual and contextual risk factors for mortality in nursing home residents during the first wave of COVID-19 in France: a multilevel analysis of a nationwide cohort study
title_fullStr Individual and contextual risk factors for mortality in nursing home residents during the first wave of COVID-19 in France: a multilevel analysis of a nationwide cohort study
title_full_unstemmed Individual and contextual risk factors for mortality in nursing home residents during the first wave of COVID-19 in France: a multilevel analysis of a nationwide cohort study
title_short Individual and contextual risk factors for mortality in nursing home residents during the first wave of COVID-19 in France: a multilevel analysis of a nationwide cohort study
title_sort individual and contextual risk factors for mortality in nursing home residents during the first wave of covid-19 in france: a multilevel analysis of a nationwide cohort study
topic Research Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10471198/
https://www.ncbi.nlm.nih.gov/pubmed/37651749
http://dx.doi.org/10.1093/ageing/afad165
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