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Beyond Chronological Age: Frailty and Multimorbidity Predict In-Hospital Mortality in Patients With COVID-19

Background: We evaluated whether frailty and multimorbidity predict in-hospital mortality in patients with COVID-19 beyond chronological age. Methods: 165 patients admitted from March 8th to April 17th, 2020, with COVID-19 in an acute geriatric ward in Italy were included. Pre-disease frailty was as...

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Autores principales: Zucchelli, Alberto, Marengoni, Alessandra, Vetrano, Davide, Ferrucci, Luigi, Fratiglioni, Laura, Bernabei, Roberto, Onder, Graziano, Romanelli, Giuseppe
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8679506/
http://dx.doi.org/10.1093/geroni/igab046.055
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author Zucchelli, Alberto
Marengoni, Alessandra
Vetrano, Davide
Ferrucci, Luigi
Fratiglioni, Laura
Bernabei, Roberto
Onder, Graziano
Romanelli, Giuseppe
author_facet Zucchelli, Alberto
Marengoni, Alessandra
Vetrano, Davide
Ferrucci, Luigi
Fratiglioni, Laura
Bernabei, Roberto
Onder, Graziano
Romanelli, Giuseppe
author_sort Zucchelli, Alberto
collection PubMed
description Background: We evaluated whether frailty and multimorbidity predict in-hospital mortality in patients with COVID-19 beyond chronological age. Methods: 165 patients admitted from March 8th to April 17th, 2020, with COVID-19 in an acute geriatric ward in Italy were included. Pre-disease frailty was assessed with the Clinical Frailty Scale (CFS). Multimorbidity was defined as the co-occurrence of ≥2 of these in the same patient. The hazard (HR) of in-hospital mortality as a function of CFS score and number of chronic diseases in the whole population and in those aged 70+ years were calculated. Results Among the 165 patients, 112 were discharged, 11 were transferred to intensive care units and 42 died. Patients who died were older (81.0 vs. 65.2 years, p<0.001), more frequently multimorbid (97.6 vs. 52.8%; p<0.001) and more likely frail (37.5 vs. 4.1%; p<0.001). Less than 2.0% of patients without multimorbidity and frailty, 28% of those with multimorbidity only and 75% of those with both multimorbidity and frailty died. Each unitary increment in the CFS was associated with a higher risk of in-hospital death in the whole sample (HR=1.3; 95%CI=1.05-1.62) and in patients aged 70+ years (HR=1.29;95%CI=1.04-1.62), whereas the number of chronic diseases was not significantly associated with higher risk of death. The CFS addition to age and sex increased mortality prediction by 9.4% in those aged 70+ years. Conclusions Frailty identifies patients with COVID-19 at risk of in-hospital death independently of age. Multimorbidity contributes to prognosis because of the very low probability of death in its absence.
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spelling pubmed-86795062021-12-17 Beyond Chronological Age: Frailty and Multimorbidity Predict In-Hospital Mortality in Patients With COVID-19 Zucchelli, Alberto Marengoni, Alessandra Vetrano, Davide Ferrucci, Luigi Fratiglioni, Laura Bernabei, Roberto Onder, Graziano Romanelli, Giuseppe Innov Aging Abstracts Background: We evaluated whether frailty and multimorbidity predict in-hospital mortality in patients with COVID-19 beyond chronological age. Methods: 165 patients admitted from March 8th to April 17th, 2020, with COVID-19 in an acute geriatric ward in Italy were included. Pre-disease frailty was assessed with the Clinical Frailty Scale (CFS). Multimorbidity was defined as the co-occurrence of ≥2 of these in the same patient. The hazard (HR) of in-hospital mortality as a function of CFS score and number of chronic diseases in the whole population and in those aged 70+ years were calculated. Results Among the 165 patients, 112 were discharged, 11 were transferred to intensive care units and 42 died. Patients who died were older (81.0 vs. 65.2 years, p<0.001), more frequently multimorbid (97.6 vs. 52.8%; p<0.001) and more likely frail (37.5 vs. 4.1%; p<0.001). Less than 2.0% of patients without multimorbidity and frailty, 28% of those with multimorbidity only and 75% of those with both multimorbidity and frailty died. Each unitary increment in the CFS was associated with a higher risk of in-hospital death in the whole sample (HR=1.3; 95%CI=1.05-1.62) and in patients aged 70+ years (HR=1.29;95%CI=1.04-1.62), whereas the number of chronic diseases was not significantly associated with higher risk of death. The CFS addition to age and sex increased mortality prediction by 9.4% in those aged 70+ years. Conclusions Frailty identifies patients with COVID-19 at risk of in-hospital death independently of age. Multimorbidity contributes to prognosis because of the very low probability of death in its absence. Oxford University Press 2021-12-17 /pmc/articles/PMC8679506/ http://dx.doi.org/10.1093/geroni/igab046.055 Text en © The Author(s) 2021. Published by Oxford University Press on behalf of The Gerontological Society of America. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) ), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Abstracts
Zucchelli, Alberto
Marengoni, Alessandra
Vetrano, Davide
Ferrucci, Luigi
Fratiglioni, Laura
Bernabei, Roberto
Onder, Graziano
Romanelli, Giuseppe
Beyond Chronological Age: Frailty and Multimorbidity Predict In-Hospital Mortality in Patients With COVID-19
title Beyond Chronological Age: Frailty and Multimorbidity Predict In-Hospital Mortality in Patients With COVID-19
title_full Beyond Chronological Age: Frailty and Multimorbidity Predict In-Hospital Mortality in Patients With COVID-19
title_fullStr Beyond Chronological Age: Frailty and Multimorbidity Predict In-Hospital Mortality in Patients With COVID-19
title_full_unstemmed Beyond Chronological Age: Frailty and Multimorbidity Predict In-Hospital Mortality in Patients With COVID-19
title_short Beyond Chronological Age: Frailty and Multimorbidity Predict In-Hospital Mortality in Patients With COVID-19
title_sort beyond chronological age: frailty and multimorbidity predict in-hospital mortality in patients with covid-19
topic Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8679506/
http://dx.doi.org/10.1093/geroni/igab046.055
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