Exploring the Association of Metabolic Syndrome with In-Hospital Survival of Older Patients Hospitalized with COVID-19: Beyond Chronological Age.

Autor: Danesh V; Center for Applied Health Research, Baylor Scott & White Research Institute, Dallas, TX, USA. Valerie.Danesh@BSWHealth.org.; Department of Medicine, Baylor College of Medicine, Houston, TX, USA. Valerie.Danesh@BSWHealth.org., Tellson A; Nursing Research, Baylor Scott & White Health, Dallas, TX, USA., Boehm LM; School of Nursing, Vanderbilt University, Nashville, TN, USA.; Critical Illness, Brain Dysfunction, and Survivorship (CIBS) Center, Vanderbilt University Medical Center, Nashville, TN, USA., Stevens AB; Center for Applied Health Research, Baylor Scott & White Research Institute, Dallas, TX, USA.; Department of Medicine, Baylor College of Medicine, Houston, TX, USA., Ogola GO; Biostatistics, Baylor Scott & White Research Institute, Dallas, TX, USA., Shrestha A; Data Core, Baylor Scott & White Research Institute, Dallas, TX, USA., Cho J; Center for Applied Health Research, Baylor Scott & White Research Institute, Dallas, TX, USA., Jimenez EJ; Baylor Scott & White Health, Dallas, TX, USA., Arroliga AC; Department of Medicine, Baylor College of Medicine, Houston, TX, USA.; Baylor Scott & White Health, Dallas, TX, USA.
Jazyk: angličtina
Zdroj: Journal of general internal medicine [J Gen Intern Med] 2024 Aug; Vol. 39 (10), pp. 1811-1819. Date of Electronic Publication: 2024 Apr 08.
DOI: 10.1007/s11606-024-08744-4
Abstrakt: Background: Despite the variability and complexity of geriatric conditions, few COVID-19 reports of clinical characteristic prognostication provide data specific to oldest-old adults (over age 85), and instead generally report broadly as 65 and older.
Objective: To examine metabolic syndrome criteria in adults across 25 hospitals with variation in chronological age.
Design and Participants: This cohort study examined 39,564 hospitalizations of patients aged 18 or older with COVID-19 who received inpatient care between March 13, 2020, and February 28, 2022.
Exposure: ICU admission and/or in-hospital mortality.
Main Measures: Metabolic syndrome criteria and patient demographics were examined as risk factors. The main outcomes were admission to ICU and hospital mortality.
Key Results: Oldest old patients (≥ 85 years) hospitalized with COVID-19 accounted for 7.0% (2758/39,564) of all adult hospitalizations. They had shorter ICU length of stay, similar overall hospitalization duration, and higher rates of discharge destinations providing healthcare services (i.e., home health, skilled nursing facility) compared to independent care. Chronic conditions varied by age group, with lower proportions of diabetes and uncontrolled diabetes in the oldest-old cohort compared with young-old (65-74 years) and middle-old (75-84 years) groups. Evaluations of the effect of metabolic syndrome and patient demographics (i.e., age, sex, race) on ICU admission demonstrate minimal change in the magnitude of effect for metabolic syndrome on ICU admission across the different models.
Conclusions: Metabolic syndrome measures are important individual predictors of COVID-19 outcomes. Building on prior examinations that metabolic syndrome is associated with death and ARDS across all ages, this analysis supports that metabolic syndrome criteria may be more relevant than chronological age as risk factors for poor outcomes attributed to COVID-19.
(© 2024. The Author(s), under exclusive licence to Society of General Internal Medicine.)
Databáze: MEDLINE
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