Frailty Assessment in the Emergency Department for Risk Stratification of COVID-19 Patients Aged ≥80 Years.
Marcello Covino, Andrea Russo, Sara Salini and 7 others
PMID 34364846WHAT IT FOUND
Higher frailty scores in the emergency department were associated with in-hospital death among patients aged 80 or older with COVID-19.
After adjustment, dementia, ADL dependency, and delirium did not independently predict death.
Key findings
01The Clinical Frailty Scale had fair predicting ability for in-hospital death, with an area under the ROC curve of 0.743 (range 0.708-0.779).
02In the adjusted Cox model, vulnerable patients had a hazard ratio of 6.93 (1.69-28.27) and frail patients had a hazard ratio of 12.55 (2.96-53.21) for in-hospital death compared with fit patients.
03Dementia, dependency in ADL, and delirium were not independent risk factors for death after adjustment.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
It was done in one urban teaching hospital emergency department in central Italy that is a COVID-19 referral center, so the results may not apply to other emergency departments. That emergency department has a dedicated geriatric unit for identifying frail patients, so the frailty assessment may have been more accurate than in a general emergency department. Patients who did not receive a complete frailty assessment or who refused were excluded; of 843 patients with positive SARS-CoV-2 tests, 729 were analysed.
The easy way to misread this
Do not rank patients by age alone. After adjustment for frailty, comorbidity, and disease severity, age was not an independent predictor of in-hospital death.