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The role of Frailty on Adverse Outcomes Among Older Patients with COVID-19

BACKGROUND: Diagnosis and screening of frailty, a condition characterized by an increased vulnerability to adverse outcomes of COVID-19, has emerged as an essential clinical tool which is strongly recommended by healthcare providers concerned with hospitalized elderly population. The data showing th...

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Autores principales: Kundi, Harun, Çetin, Elif Hande Özcan, Canpolat, Uğur, Aras, Sevgi, Celik, Osman, Ata, Naim, Birinci, Suayip, Çay, Serkan, Özeke, Özcan, Tanboğa, Ibrahim Halil, Topaloğlu, Serkan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The British Infection Association. Published by Elsevier Ltd. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7521439/
https://www.ncbi.nlm.nih.gov/pubmed/33002560
http://dx.doi.org/10.1016/j.jinf.2020.09.029
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author Kundi, Harun
Çetin, Elif Hande Özcan
Canpolat, Uğur
Aras, Sevgi
Celik, Osman
Ata, Naim
Birinci, Suayip
Çay, Serkan
Özeke, Özcan
Tanboğa, Ibrahim Halil
Topaloğlu, Serkan
author_facet Kundi, Harun
Çetin, Elif Hande Özcan
Canpolat, Uğur
Aras, Sevgi
Celik, Osman
Ata, Naim
Birinci, Suayip
Çay, Serkan
Özeke, Özcan
Tanboğa, Ibrahim Halil
Topaloğlu, Serkan
author_sort Kundi, Harun
collection PubMed
description BACKGROUND: Diagnosis and screening of frailty, a condition characterized by an increased vulnerability to adverse outcomes of COVID-19, has emerged as an essential clinical tool which is strongly recommended by healthcare providers concerned with hospitalized elderly population. The data showing the role of frailty in patients infected with COVID-19 is needed. METHODS: This was a nationwide cohort study conducted at all hospitals in Turkey. All COVID-19 hospitalized patients (≥ 65 years) were included. Patients who were alive and not discharged up to July 20, 2020, were excluded. The frailty was assessed by using the “Hospital Frailty Risk Score” (HFRS). Patients were classified into three risk groups of frailty based on previously validated cut points as low (<5 points), intermediate (5-15 points), and high (>15 points). Additionally, patients who had the HFRS of ≥5 were defined as frail. The primary outcome was in-hospital mortality rates by frailty group. RESULTS: Between March 11, 2020, and June 22, 2020, a total of 18,234 COVID-19 patients from all of 81 provinces of Turkey were included. Totally, 12,295 (67.4%) patients were defined as frail (HFRS of >5) of which 2,801 (15.4%) patients were categorized in the highest level of frailty (HFRS of >15). Observed in-hospital mortality rates were 697 (12.0%), 1,751 (18.2%) and 867 (31.0%) in low, intermediate and high hospital frailty risk, respectively (p<0.001). Compared with low HFRS (<5), the adjusted odds ratios for in-hospital mortality were 1.482 (1.334-1.646) for intermediate HFRS (5-15) and 2.084; 95% CI, 1.799-2.413 for high HFRS (>15). CONCLUSIONS: As a claims-based frailty model, the HFRS provides clinicians and health systems, a standardized tool for an effective detection and grading of frailty in patients in COVID-19. A frailty-based tailored management of the older population may provide a more accurate risk categorization for both therapeutic and preventive strategies.
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spelling pubmed-75214392020-09-29 The role of Frailty on Adverse Outcomes Among Older Patients with COVID-19 Kundi, Harun Çetin, Elif Hande Özcan Canpolat, Uğur Aras, Sevgi Celik, Osman Ata, Naim Birinci, Suayip Çay, Serkan Özeke, Özcan Tanboğa, Ibrahim Halil Topaloğlu, Serkan J Infect Article BACKGROUND: Diagnosis and screening of frailty, a condition characterized by an increased vulnerability to adverse outcomes of COVID-19, has emerged as an essential clinical tool which is strongly recommended by healthcare providers concerned with hospitalized elderly population. The data showing the role of frailty in patients infected with COVID-19 is needed. METHODS: This was a nationwide cohort study conducted at all hospitals in Turkey. All COVID-19 hospitalized patients (≥ 65 years) were included. Patients who were alive and not discharged up to July 20, 2020, were excluded. The frailty was assessed by using the “Hospital Frailty Risk Score” (HFRS). Patients were classified into three risk groups of frailty based on previously validated cut points as low (<5 points), intermediate (5-15 points), and high (>15 points). Additionally, patients who had the HFRS of ≥5 were defined as frail. The primary outcome was in-hospital mortality rates by frailty group. RESULTS: Between March 11, 2020, and June 22, 2020, a total of 18,234 COVID-19 patients from all of 81 provinces of Turkey were included. Totally, 12,295 (67.4%) patients were defined as frail (HFRS of >5) of which 2,801 (15.4%) patients were categorized in the highest level of frailty (HFRS of >15). Observed in-hospital mortality rates were 697 (12.0%), 1,751 (18.2%) and 867 (31.0%) in low, intermediate and high hospital frailty risk, respectively (p<0.001). Compared with low HFRS (<5), the adjusted odds ratios for in-hospital mortality were 1.482 (1.334-1.646) for intermediate HFRS (5-15) and 2.084; 95% CI, 1.799-2.413 for high HFRS (>15). CONCLUSIONS: As a claims-based frailty model, the HFRS provides clinicians and health systems, a standardized tool for an effective detection and grading of frailty in patients in COVID-19. A frailty-based tailored management of the older population may provide a more accurate risk categorization for both therapeutic and preventive strategies. The British Infection Association. Published by Elsevier Ltd. 2020-12 2020-09-28 /pmc/articles/PMC7521439/ /pubmed/33002560 http://dx.doi.org/10.1016/j.jinf.2020.09.029 Text en © 2020 The British Infection Association. Published by Elsevier Ltd. All rights reserved. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
spellingShingle Article
Kundi, Harun
Çetin, Elif Hande Özcan
Canpolat, Uğur
Aras, Sevgi
Celik, Osman
Ata, Naim
Birinci, Suayip
Çay, Serkan
Özeke, Özcan
Tanboğa, Ibrahim Halil
Topaloğlu, Serkan
The role of Frailty on Adverse Outcomes Among Older Patients with COVID-19
title The role of Frailty on Adverse Outcomes Among Older Patients with COVID-19
title_full The role of Frailty on Adverse Outcomes Among Older Patients with COVID-19
title_fullStr The role of Frailty on Adverse Outcomes Among Older Patients with COVID-19
title_full_unstemmed The role of Frailty on Adverse Outcomes Among Older Patients with COVID-19
title_short The role of Frailty on Adverse Outcomes Among Older Patients with COVID-19
title_sort role of frailty on adverse outcomes among older patients with covid-19
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7521439/
https://www.ncbi.nlm.nih.gov/pubmed/33002560
http://dx.doi.org/10.1016/j.jinf.2020.09.029
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