The impact of frailty on intra-hospital survival in older patients with COVID-19 infection: the importance of early identification. SEMI-COVID National Registry.

Autor: López-Sampalo A; Internal Medicine Department, Regional University Hospital of Málaga, Instituto de Investigación Biomedica de Málaga (IBIMA- Plataforma BIONAND), University of Málaga (UMA), Málaga, Spain., Hernández-Negrín H; Internal Medicine Department, Regional University Hospital of Málaga, Instituto de Investigación Biomedica de Málaga (IBIMA- Plataforma BIONAND), University of Málaga (UMA), Málaga, Spain., Bernal-López MR; Internal Medicine Department, Regional University Hospital of Málaga, Instituto de Investigación Biomedica de Málaga (IBIMA- Plataforma BIONAND), University of Málaga (UMA), Málaga, Spain; Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain. Electronic address: rosa.bernal@ibima.eu., Rubio-Rivas M; Internal Medicine Department, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, University of Barcelona, Barcelona, Spain., Martín-Escalante MD; Internal Medicine Department, Costa del Sol Hospital, Marbella, Málaga, Spain., Wikman-Jogersen P; Internal Medicine Department, San Juan University Hospital, Alicante, Spain., García-Reyne A; Internal Medicine Department, 12 de Octubre University Hospital, Madrid, Spain., Fernández-Madera Martínez R; Internal Medicine Department, Cabueñes University Hospital, Gijón, Spain., Gómez-Antúnez M; Internal Medicine Department, Gregorio Marañón University Hospital, Madrid, Spain., Beato-Pérez JL; Internal Medicine Department, Albacete University Hospital Complex, Albacete, Spain., Torres-Peña JD; Internal Medicine Department, Reina Sofia University Hospital, Córdoba, Spain., Martín-Oterino JA; Internal Medicine Department, Salamanca University Health Care Complex, Salamanca, Spain., Loureiro-Amigo J; Internal Medicine Department, Moisès Broggi Hospital, Sant Joan Despí, Barcelona, Spain., Vicente de la Sota J; Internal Medicine Department, Infanta Cristina University Hospital, Parla, Madrid, Spain., Gil-Sánchez R; Internal Medicine Department, La Fe University Hospital, Valencia, Spain., Lorenzo-López Reboiro M; Internal Medicine Department, Regional Hospital of Monforte de Lemos, Monforte de Lemos, Lugo, Spain., Bernal-Román B; Pneumology Department, Doctor José Molina Orosa University Hospital, Arrecife, Lanzarote, Spain., Fernández-Sola J; Internal Medicine Department, Clinic Hospital, Barcelona, Spain., Amorós-Martínez F; Internal Medicine Department, Vinalopó Hospital, Alicante, Spain., Vicente-López N; Internal Medicine Department, Sureste University Hospital, Arganda del Rey, Madrid, Spain., Valle-Bernard R; Internal Medicine Department, Sierrallana Hospital, Torrelavega, Cantabria, Spain., López-Ruiz A; Internal Medicine Department, Axarquía Hospital, Vélez-Málaga, Málaga, Spain., Ramos-Rincón JM; Department of Clinical Medicine, Miguel Hernandez University of Elche, Alicante, Spain., Gómez-Huelgas R; Internal Medicine Department, Regional University Hospital of Málaga, Instituto de Investigación Biomedica de Málaga (IBIMA- Plataforma BIONAND), University of Málaga (UMA), Málaga, Spain; Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain.
Jazyk: angličtina
Zdroj: Revista clinica espanola [Rev Clin Esp (Barc)] 2023 Oct; Vol. 223 (8), pp. 461-469. Date of Electronic Publication: 2023 Jul 16.
DOI: 10.1016/j.rceng.2023.07.004
Abstrakt: Background: Emerging evidence suggests that frailty may be a significant predictor of poor outcomes in older individuals hospitalized due to COVID-19. This study aims to determine the prognostic value of frailty on intrahospital patient survival.
Methods: This observational, multicenter, nationwide study included patients aged 70 years and older who were hospitalized due to COVID-19 in Spain between March 1 and December 31, 2020. Patient data were obtained from the SEMI-COVID-19 Registry of the Spanish Society of Internal Medicine. Frailty was assessed using the Clinical Frailty Scale. The primary outcome was hospital survival. Cox proportional hazards models were used to assess predictors of survival.
Results: A total of 1,878 participants (52% men and 48% women) were included, with 1,351 (71.9%) survivors and 527 (28.1%) non-survivors. The non-survivor group had higher mean age (83.5 vs. 81 years), comorbidities (6.3 vs. 5.3 points on the Charlson index), degree of dependency (26.8% vs. 12.4% severely dependent patients), and frailty (34.5% vs. 14.7% severely frail patients) compared to survivors. However, there were no differences in terms of sex. Our results demonstrate that a moderate-severe degree of frailty is the primary factor independently associated with shorter survival [HR 2.344 (1.437-3.823; p<0.001) for CFS 5-6 and 3.694 (2.155-6.330; p<0.001) for CFS 7-9].
Conclusion: Frailty is the main predictor of adverse outcomes in older patients with COVID-19. The utilization of tools such as the Clinical Frailty Scale is crucial for early detection in this population.
(Copyright © 2023 Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI). All rights reserved.)
Databáze: MEDLINE
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