Rapid Assessment at Hospital Admission of Mortality Risk From COVID-19: The Role of Functional Status.
Olga Laosa, Laura Pedraza, Alejandro Álvarez-Bustos and 3 others
PMID 33160872WHAT IT FOUND
In 375 hospitalized adults with COVID-19, lower everyday function at admission was linked to higher risk of dying in hospital, even after age and illnesses were considered.
Key findings
01The cohort included 375 hospitalized patients; 74 died and 299 recovered and were discharged before the end of follow-up.
02Each 5-point lower Barthel Index score at admission was associated with higher odds of in-hospital death, even after adjustment for age, sex, qSOFA, polypharmacy and comorbidities.
03Predicted in-hospital mortality risk ranged from 0% to 78% across combinations of age, sex, comorbidities, qSOFA and Barthel Index.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
This was a single-center cohort from one month at the peak of the first Madrid wave, so it may not apply to other hospitals or later pandemic periods. The study is observational; it shows an association between lower function and death, not that poor function caused death. Two patients were still hospitalized and five patients lacked Barthel data and were excluded from some analyses. Only 7 patients lived in nursing homes, so the findings may not apply to nursing-home residents. The mortality risk tables were developed from the same data and were not tested in a separate sample. Functional status was recorded from clinical records, and for some patients it was reconstructed from primary care records rather than measured at admission.
The easy way to misread this
Do not read this as proof that poor function causes death or that the risk tables are validated. The study was observational, from one hospital during one peak month, and the risk tables were derived from the same data rather than tested separately.