The impact of frailty on survival in elderly intensive care patients with COVID-19 : the COVIP study
Jung, Christian (Heinrich-Heine-University Duesseldorf)
Flaatten, Hans (Haukeland University Hospital (Noruega))
Fjølner, Jesper (Aarhus University Hospital (Aarhus, Dinamarca))
Bruno, Raphael Romano (Heinrich-Heine-University Duesseldorf)
Wernly, Bernhard (Paracelsus Medical University)
Artigas Raventós, Antoni (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Bollen Pinto, Bernardo (Geneva University Hospitals (Suïssa))
Schefold, Joerg C. (University of Bern)
Wolff, Georg (Heinrich-Heine-University Duesseldorf)
Kelm, Malte (Heinrich-Heine-University Duesseldorf)
Beil, Michael (Hadassah University Medical Center)
Sviri, Sigal (Hadassah University Medical Center)
van Heerden, Peter Vernon (Hadassah University Medical Center)
Szczeklik, Wojciech (Jagiellonian University Medical College)
Czuczwar, Miroslaw (Medical University of Lublin)
Elhadi, Muhammed (University of Tripoli)
Joannidis, Michael (Medical University Innsbruck)
Oeyen, Sandra (Universitair Ziekenhuis Gent)
Zafeiridis, Tilemachos (General University Hospital of Larissa (Grècia))
Marsh, Brian (Mater Misericordiae University Hospital(Dublín, Irlanda))
Andersen, Finn H. (Norwegian University of Science and Technology)
Moreno, Rui (Centro Hospitalar Universitário de Lisboa Central)
Cecconi, Maurizio (Humanitas University (Itàlia))
Leaver, Susannah (St George's University Hospitals NHS Foundation Trust)
Boumendil, Ariane (Hôpitaux de Paris)
De Lange, Dylan W.. (University Utrecht)
Guidet, Bertrand (Hôpitaux de Paris)
Universitat Autònoma de Barcelona

Data:	2021
Resum:	The COVID-19 pandemic has led highly developed healthcare systems to the brink of collapse due to the large numbers of patients being admitted into hospitals. One of the potential prognostic indicators in patients with COVID-19 is frailty. The degree of frailty could be used to assist both the triage into intensive care, and decisions regarding treatment limitations. Our study sought to determine the interaction of frailty and age in elderly COVID-19 ICU patients. A prospective multicentre study of COVID-19 patients ≥ 70 years admitted to intensive care in 138 ICUs from 28 countries was conducted. The primary endpoint was 30-day mortality. Frailty was assessed using the clinical frailty scale. Additionally, comorbidities, management strategies and treatment limitations were recorded. The study included 1346 patients (28% female) with a median age of 75 years (IQR 72-78, range 70-96), 16. 3% were older than 80 years, and 21% of the patients were frail. The overall survival at 30 days was 59% (95% CI 56-62), with 66% (63-69) in fit, 53% (47-61) in vulnerable and 41% (35-47) in frail patients (p < 0. 001). In frail patients, there was no difference in 30-day survival between different age categories. Frailty was linked to an increased use of treatment limitations and less use of mechanical ventilation. In a model controlling for age, disease severity, sex, treatment limitations and comorbidities, frailty was independently associated with lower survival. Frailty provides relevant prognostic information in elderly COVID-19 patients in addition to age and comorbidities. Trial registration Clinicaltrials. gov: , registered 19 March 2020. The online version contains supplementary material available at 10. 1186/s13054-021-03551-3.
Ajuts:	European Commission. Horizon 2020 831644
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	COVID-19 ; Frailty ; Outcome ; Elderly ; Pandemia
Publicat a:	Critical Care, Vol. 25 (april 2021) , ISSN 1466-609X

DOI: 10.1186/s13054-021-03551-3
PMID: 33874987

9 p, 994.6 KB

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Documents de recerca > Documents dels grups de recerca de la UAB > Centres i grups de recerca (producció científica) > Ciències de la salut i biociències > Institut d’Investigació i Innovació Parc Taulí (I3PT)
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