Predictors of In-Hospital Mortality in Older Patients With COVID-19: The COVIDAge Study.
Aline Mendes, Christine Serratrice, François R Herrmann and 14 others
PMID 33138936WHAT IT FOUND
In older hospitalized patients with COVID-19, male sex, crackles, needing more oxygen, and lower functional status were associated with death.
Age alone was not. These factors together did not reliably identify who would die.
Key findings
0176 of 235 patients died during hospitalization, a mortality rate of 32%.
02Male sex, need for increased FiO2, and crackles at admission were associated with mortality, while absence of functional decline was protective.
03Chronological age alone was not significantly different between survivors and nonsurvivors.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
This was a retrospective single-center study using information from medical records, so missing data could not be retrieved. The endpoint was in-hospital mortality without a fixed follow-up period. The sample was 235 Caucasian hospitalized older patients who did not wish or were deemed ineligible for intensive care, so results may not generalize to other older populations or to patients admitted to intensive care. Clinical scales such as delirium, frailty, and function involved clinician judgment, and the authors note possible variability in ratings. The best model was not sufficient to predict mortality on a per-patient level. The study is observational, so it shows associations, not that any treatment or therapy caused survival.
The easy way to misread this
Do not use age, frailty, or a low functional score by itself to decide that an older patient with COVID-19 should not receive intensive care. This was an observational study of associations, not tested interventions, and the authors state that its data are not suitable to support triage decisions toward intensive care.