Age, Frailty, and Comorbidity as Prognostic Factors for Short-Term Outcomes in Patients With Coronavirus Disease 2019 in Geriatric Care.
Sara Hägg, Juulia Jylhävä, Yunzhang Wang and 12 others
PMID 32978065WHAT IT FOUND
In 250 older hospital patients with COVID-19, 24% died in hospital and 44% went home; 76% survived.
Frailty, comorbidity, age, and acute kidney injury predicted death.
Key findings
01Among the 250 geriatric patients with COVID-19, 24% (59/250) died in hospital and 44% (110/250) were discharged to home.
02Older age, frailty defined as CFS >5, higher comorbidity index, and acute kidney injury were associated with in-hospital mortality in patients with COVID-19.
03Frailty defined as CFS >5 was associated with a lower probability of discharge to home, while higher Hospital Frailty Risk Score was not associated with mortality.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was done in a geriatric inpatient unit in Stockholm, so it may not apply to older people in other settings or in the community. Follow-up was short-term and based on in-hospital records, so outcomes after discharge were not reported. Patients had different follow-up times, and some Clinical Frailty Scale scores were missing. Comorbidities were recorded only if relevant to the current admission, so other diagnoses may have been underreported. Because the sample was selected, some associations may be due to selection or collider bias, and the hypertension finding may be an artifact. Sex-stratified analyses had low power, so sex differences were not established.
The easy way to misread this
Do not conclude that hospital care is futile for frail older patients with COVID-19. In this sample, 76% survived and 44% were discharged to home, and the authors state that frailty is not synonymous with end-of-life.