Age and frailty are independently associated with increased COVID-19 mortality and increased care needs in survivors: results of an international multi-centre study.
Age and frailty are independently associated with increased COVID-19 mortality and increased care needs in survivors: results of an international multi-centre study.
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DOI：
10.1093/ageing/afab026
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发表时间：
2021-05-05
期刊：
影响因子：
6.7
通讯作者：
Welch C
中科院分区：
文献类型：
--
作者：
Geriatric Medicine Research Collaborative;Covid Collaborative;Welch C
2019冠状病毒病（COVID-19）老年人的死亡率增加，但虚弱的影响尚不清楚。这项多中心队列研究涉及18岁及以上因COVID-19住院的患者，使用常规收集的数据。我们使用考克斯回归分析来评估年龄、虚弱和谵妄对住院死亡风险的影响，并调整性别、疾病严重程度、炎症和合并症。我们使用有序逻辑回归分析来评估年龄、临床虚弱量表（CFS）和谵妄对出院时护理需求增加风险的影响，并对相同的变量进行调整。纳入了来自12个国家55家医院的5，711例患者的数据（中位年龄74岁，四分位距[IQR] 54-83; 55.2%为男性）。死亡风险随着年龄的增加而独立增加（>80 vs 18-49：风险比[HR] 3.57，置信区间[CI] 2.54-5.02），虚弱（CFS 8 vs 1-3：HR 3.03，CI 2.29-4.00）炎症，肾脏疾病，心血管疾病和癌症，但不是谵妄。年龄、虚弱（CFS 7与1-3：比值比7.00，CI 5.27-9.32）、谵妄、痴呆和精神健康诊断均与出院时更高护理需求的风险增加相关。CFS所有级别的不良结果可能性均从4级增加到9级。年龄和虚弱与COVID-19的不良结局独立相关。身体虚弱或年龄较大的COVID-19幸存者的护理需求增加的风险也有所增加。
Increased mortality has been demonstrated in older adults with coronavirus disease 2019 (COVID-19), but the effect of frailty has been unclear. This multi-centre cohort study involved patients aged 18 years and older hospitalised with COVID-19, using routinely collected data. We used Cox regression analysis to assess the impact of age, frailty and delirium on the risk of inpatient mortality, adjusting for sex, illness severity, inflammation and co-morbidities. We used ordinal logistic regression analysis to assess the impact of age, Clinical Frailty Scale (CFS) and delirium on risk of increased care requirements on discharge, adjusting for the same variables. Data from 5,711 patients from 55 hospitals in 12 countries were included (median age 74, interquartile range [IQR] 54–83; 55.2% male). The risk of death increased independently with increasing age (>80 versus 18–49: hazard ratio [HR] 3.57, confidence interval [CI] 2.54–5.02), frailty (CFS 8 versus 1–3: HR 3.03, CI 2.29–4.00) inflammation, renal disease, cardiovascular disease and cancer, but not delirium. Age, frailty (CFS 7 versus 1–3: odds ratio 7.00, CI 5.27–9.32), delirium, dementia and mental health diagnoses were all associated with increased risk of higher care needs on discharge. The likelihood of adverse outcomes increased across all grades of CFS from 4 to 9. Age and frailty are independently associated with adverse outcomes in COVID-19. Risk of increased care needs was also increased in survivors of COVID-19 with frailty or older age.
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脓毒症病理生理学、慢性危重疾病、持续性炎症-免疫抑制和分解代谢综合征。
影响因子：
8.8
作者：
Mira JC;Gentile LF;Mathias BJ;Efron PA;Brakenridge SC;Mohr AM;Moore FA;Moldawer LL
通讯作者：
Moldawer LL
影响因子：
6.3
作者：
Garcez, Flavia B.;Aliberti, Marlon J. R.;Avelino-Silva, Thiago J.
通讯作者：
Avelino-Silva, Thiago J.
影响因子：
39.2
作者：
Levey, Andrew S.;Coresh, Josef;Van Lente, Frederick
通讯作者：
Van Lente, Frederick
影响因子：
3.8
作者：
Miles, Amy;Webb, Thomas E.;Davis, Daniel
通讯作者：
Davis, Daniel
DOI：
10.1016/j.bbi.2016.02.024
发表时间：
2016-08
期刊：
Brain, behavior, and immunity
影响因子：
--
作者：
Bartlett DB;Fox O;McNulty CL;Greenwood HL;Murphy L;Sapey E;Goodman M;Crabtree N;Thøgersen-Ntoumani C;Fisher JP;Wagenmakers AJ;Lord JM
通讯作者：
Lord JM