COVID-19-Associated Outcomes of Critical Illness in Patients with Frailty: a Cohort Study.

IF 1.6 Q4 GERIATRICS & GERONTOLOGY Canadian Geriatrics Journal Pub Date : 2024-09-05 eCollection Date: 2024-09-01 DOI:10.5770/cgj.27.731

Carmel L Montgomery, Andrea Davenport, Lazar Milovanovic, Sean M Bagshaw, Darryl B Rolfson, Oleksa G Rewa

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Abstract

Background: Pre-admission frailty has been associated with higher hospital mortality in patients with critical illness. We aimed to measure the prevalence of frailty and its associated outcomes in patients with COVID-19 critical illness.

Methods: A historical cohort study of all adults admitted to ICU with a pneumonia diagnosis in Alberta, Canada between May 1, 2020, and October 31, 2020. At ICU admission patients were routinely assessed for frailty using the Clinical Frailty Scale (CFS). Frailty was defined as a CFS score ≥5. Primary outcomes were pre-admission frailty prevalence and hospital mortality.

Results: The cohort (n=521) prevalence of frailty was 34.2% (n=178), mean (SD) age was 58.8 (14.9) years, APACHE II 22.8 (8.0), and 39.5% (n=206) were female. COVID-19 pneumonia was diagnosed in (19.0%; n=99) admissions; pre-admission frailty was present in 20.2% (n=20) vs. 79.8% (n=79) non-frail (p<.001). Among ICU patients admitted with COVID-19, hospital mortality in frail patients was 35.4% (n=63) vs. 14.0% (n=48) in non-frail (p<.001).

Conclusion: Pre-admission frailty was present in 20.2% of COVID-19 ICU admissions and was associated with higher risk of hospital mortality. Frailty assessment may yield valuable prognostic information when considering COVID-19 ICU admission; however, further study is needed to identify effect on patient-centred outcomes in this heterogeneous population.

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COVID-19-体弱患者危重症的相关结果：一项队列研究。

背景：入院前体弱与危重症患者较高的住院死亡率有关。我们的目的是测量 COVID-19 危重症患者的虚弱发生率及其相关结果：对加拿大艾伯塔省 2020 年 5 月 1 日至 2020 年 10 月 31 日期间因肺炎诊断入住重症监护室的所有成人进行历史队列研究。在入住 ICU 时，使用临床虚弱量表 (CFS) 对患者进行常规虚弱评估。体弱的定义是 CFS 评分≥5 分。主要结果是入院前的虚弱患病率和住院死亡率：队列（n=521）中虚弱患病率为 34.2%（n=178），平均（标清）年龄为 58.8（14.9）岁，APACHE II 为 22.8（8.0）分，39.5%（n=206）为女性。入院诊断为 COVID-19 肺炎的比例为 19.0%；n=99；入院前体弱的比例为 20.2%（n=20），而非体弱的比例为 79.8%（n=79）：20.2%的COVID-19重症监护病房入院患者存在入院前体弱的情况，并与较高的住院死亡风险相关。在考虑COVID-19 ICU入院时，虚弱评估可能会提供有价值的预后信息；但是，还需要进一步研究，以确定对这一异质性人群以患者为中心的预后的影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Canadian Geriatrics Journal Nursing-Gerontology

CiteScore

5.20

自引率

0.00%

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期刊介绍： The Canadian Geriatrics Journal (CGJ) is a peer-reviewed publication that is a home for innovative aging research of a high quality aimed at improving the health and the care provided to older persons residing in Canada and outside our borders. While we gratefully accept submissions from researchers outside our country, we are committed to encouraging aging research by Canadians. The CGJ is targeted to family physicians with training or an interest in the care of older persons, specialists in geriatric medicine, geriatric psychiatrists, and members of other health disciplines with a focus on gerontology.