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Scope of treatment and clinical-decision making in the older patient with COVID-19 infection, a European perspective

PURPOSE: Older patients were particularly vulnerable to severe COVID-19 disease resulting in high in-hospital mortality rates during the two first waves. The aims of this study were to better characterize the management of older people presenting with COVID-19 in European hospitals and to identify n...

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Autores principales: van Bruchem-Visser, Rozemarijn Lidewij, Vankova, Hana, Rexach, Lourdes, Ahmed, Marc Vali, Burns, Eileen, Pautex, Sophie, Piers, Ruth
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9735039/
https://www.ncbi.nlm.nih.gov/pubmed/36477605
http://dx.doi.org/10.1007/s41999-022-00721-6
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author van Bruchem-Visser, Rozemarijn Lidewij
Vankova, Hana
Rexach, Lourdes
Ahmed, Marc Vali
Burns, Eileen
Pautex, Sophie
Piers, Ruth
author_facet van Bruchem-Visser, Rozemarijn Lidewij
Vankova, Hana
Rexach, Lourdes
Ahmed, Marc Vali
Burns, Eileen
Pautex, Sophie
Piers, Ruth
author_sort van Bruchem-Visser, Rozemarijn Lidewij
collection PubMed
description PURPOSE: Older patients were particularly vulnerable to severe COVID-19 disease resulting in high in-hospital mortality rates during the two first waves. The aims of this study were to better characterize the management of older people presenting with COVID-19 in European hospitals and to identify national guidelines on hospital admission and ICU admission for this population. METHODS: Online survey based on a vignette of a frail older patient with Covid-19 distributed by e-mail to all members of the European Geriatric Medicine Society. The survey contained questions regarding the treatment of the vignette patient as well as general questions regarding available services. Additionally, questions on national policies and differences between the first and second wave of the pandemic were asked. RESULTS: Survey of 282 respondents from 28 different countries was analyzed. Responses on treatment of the patient in the vignette were similar from respondents across the 28 countries. 247 respondents (87%) would admit the patient to the hospital, in most cases to a geriatric COVID-19 ward (78%). Cardiopulmonary resuscitation was found medically inappropriate by 85% of respondents, intubation and mechanical ventilation by 91% of respondents, admission to the ICU by 82%, and ExtraCorpular Membrane Oxygenation (ECMO) by 93%. Sixty percent of respondents indicated they would consult with a palliative care specialist, 56% would seek the help of a spiritual counsellor. National guidelines on admission criteria of geriatric patients to the hospital existed in 22 different European countries. CONCLUSION: This pandemic has fostered the collaboration between geriatricians and palliative care specialists to improve the care for older patients with a severe disease and often an uncertain prognosis. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s41999-022-00721-6.
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spelling pubmed-97350392022-12-12 Scope of treatment and clinical-decision making in the older patient with COVID-19 infection, a European perspective van Bruchem-Visser, Rozemarijn Lidewij Vankova, Hana Rexach, Lourdes Ahmed, Marc Vali Burns, Eileen Pautex, Sophie Piers, Ruth Eur Geriatr Med Research Paper PURPOSE: Older patients were particularly vulnerable to severe COVID-19 disease resulting in high in-hospital mortality rates during the two first waves. The aims of this study were to better characterize the management of older people presenting with COVID-19 in European hospitals and to identify national guidelines on hospital admission and ICU admission for this population. METHODS: Online survey based on a vignette of a frail older patient with Covid-19 distributed by e-mail to all members of the European Geriatric Medicine Society. The survey contained questions regarding the treatment of the vignette patient as well as general questions regarding available services. Additionally, questions on national policies and differences between the first and second wave of the pandemic were asked. RESULTS: Survey of 282 respondents from 28 different countries was analyzed. Responses on treatment of the patient in the vignette were similar from respondents across the 28 countries. 247 respondents (87%) would admit the patient to the hospital, in most cases to a geriatric COVID-19 ward (78%). Cardiopulmonary resuscitation was found medically inappropriate by 85% of respondents, intubation and mechanical ventilation by 91% of respondents, admission to the ICU by 82%, and ExtraCorpular Membrane Oxygenation (ECMO) by 93%. Sixty percent of respondents indicated they would consult with a palliative care specialist, 56% would seek the help of a spiritual counsellor. National guidelines on admission criteria of geriatric patients to the hospital existed in 22 different European countries. CONCLUSION: This pandemic has fostered the collaboration between geriatricians and palliative care specialists to improve the care for older patients with a severe disease and often an uncertain prognosis. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s41999-022-00721-6. Springer International Publishing 2022-12-08 2023 /pmc/articles/PMC9735039/ /pubmed/36477605 http://dx.doi.org/10.1007/s41999-022-00721-6 Text en © The Author(s), under exclusive licence to European Geriatric Medicine Society 2022, Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.
spellingShingle Research Paper
van Bruchem-Visser, Rozemarijn Lidewij
Vankova, Hana
Rexach, Lourdes
Ahmed, Marc Vali
Burns, Eileen
Pautex, Sophie
Piers, Ruth
Scope of treatment and clinical-decision making in the older patient with COVID-19 infection, a European perspective
title Scope of treatment and clinical-decision making in the older patient with COVID-19 infection, a European perspective
title_full Scope of treatment and clinical-decision making in the older patient with COVID-19 infection, a European perspective
title_fullStr Scope of treatment and clinical-decision making in the older patient with COVID-19 infection, a European perspective
title_full_unstemmed Scope of treatment and clinical-decision making in the older patient with COVID-19 infection, a European perspective
title_short Scope of treatment and clinical-decision making in the older patient with COVID-19 infection, a European perspective
title_sort scope of treatment and clinical-decision making in the older patient with covid-19 infection, a european perspective
topic Research Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9735039/
https://www.ncbi.nlm.nih.gov/pubmed/36477605
http://dx.doi.org/10.1007/s41999-022-00721-6
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