Preparing for future pandemics: frailty associates with mortality in hospitalised older people during the entire COVID-19 pandemic, a Dutch multicentre cohort study.

Purpose

Viral mutations and improved prevention or treatment options may have changed the association of frailty with mortality throughout the COVID-19 pandemic. We investigated how associations of frailty with in-hospital mortality changed throughout the pandemic in older people hospitalised for COVID-19.

Methods

The COVID-OLD study included COVID-19 patients aged ≥ 70 years hospitalised during the first (early 2020), second (late 2020), third (late 2021) or fourth wave (early 2022). Based on the clinical frailty scale, patients were categorised as fit (1-3), pre-frail (4-5) or frail (6-9). Associations of frailty with in-hospital mortality were assessed with pairwise comparisons with fit as reference category and modelled using binary logistic regression adjusted for age and sex.

Results

This study included 2362 patients (mean age 79.7 years, 60% men). In the first wave, in-hospital mortality was 46% in patients with frailty and 27% in fit patients. In-hospital mortality decreased in each subsequent wave to 25% in patients with frailty and 11% in fit patients in the fourth wave. After adjustments, an overall higher risk of in-hospital mortality was found in frail (OR 2.26, 95% CI: 1.66-3.07) and pre-frail (OR 1.73, 95% CI: 1.27-2.35) patients compared to fit patients, which did not change over time (p for interaction = 0.74).

Conclusions

Frailty remained associated with a higher risk of in-hospital mortality throughout the entire COVID-19 pandemic, although overall in-hospital mortality rates decreased. Frailty therefore remains a relevant risk factor in all stages of a pandemic and is important to consider in prevention and treatment guidelines for future pandemics.

© 2024. The Author(s).

Overzicht publicatie

TitelPreparing for future pandemics: frailty associates with mortality in hospitalised older people during the entire COVID-19 pandemic, a Dutch multicentre cohort study.
Datum7 juni 2024
Tijdschrift naamEuropean geriatric medicine
Tijdschrift nummerpubmed:38849648
DOI10.1007/s41999-024-01001-1
PubMed38849648
Auteursvan Raaij BFM, Noordam R, Smits RAL, van der Klei VMGTH, Jansen SWM, van der Linden CMJ, Polinder-Bos HA, Minnema J, Tap L, van der Bol JM, van de Glind EMM, Willems HC, van Deudekom FJA, Ruiter R, van Munster BC, Robben SHM, Schouten HJ, Barten DG, Lucke JA, Peeters G, Trompet S, Drewes YM, van den Bos F, Gussekloo J & Mooijaart SP
InformatieCOOP study group, Mooijaart SP, Polinder-Bos HA, Moons KGM, Smeden M, Peeters G, Melis RJF, Elders PJM, Festen J
TrefwoordenCOVID-19, Frailty, In-hospital mortality
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