Comparing associations between frailty and mortality in hospitalised older adults with or without COVID-19 infection: a retrospective observational study using electronic health records. Owen, R., Conroy, S., Taub, N., Jones, W., Bryden, D., Pareek, M., Faull, C., Abrams, K., Davis, D., & Banerjee, J. Age and Ageing, July, 2020.
doi  abstract   bibtex   
BACKGROUND: The aim of this study was to describe outcomes in hospitalised older people with different levels of frailty and COVID-19 infection. METHODS: We undertook a single centre, retrospective cohort study examining COVID-19 related mortality using Electronic Health Records, for older people (65 and over) with frailty, hospitalised with or without COVID-19 infection. Baseline covariates included demographics, Early Warning Scores, Charlson Comorbidity Indices and frailty (Clinical Frailty Scale, CFS), linked to COVID-19 status. FINDINGS: We analysed outcomes on 1,071 patients with COVID-19 test results; 285 (27%) were positive for COVID-19.)The mean age at ED arrival was 79.7 and 49.4% were female. All-cause mortality (by 30 days) rose from 9% (not frail) through to 33% (severely frail) in the COVID negative cohort but was around 60% for all frailty categories in the COVID positive cohort. In adjusted analyses, the hazard ratio for death in those with COVID-19 compared to those without COVID-19 was 7.3, 95% CI: 3.00, 18.0) with age, comorbidities and illness severity making small additional contributions. INTERPRETATION: In this study frailty, measured using the Clinical Frailty Scale, appeared to make little incremental contribution to the hazard of dying in older people hospitalised with COVID-19 infection; illness severity and comorbidity had a modest association with the overall adjusted hazard of death, whereas confirmed COVID-19 infection dominated, with a seven-fold hazard for death.
@article{owen_comparing_2020,
	title = {Comparing associations between frailty and mortality in hospitalised older adults with or without {COVID}-19 infection: a retrospective observational study using electronic health records},
	issn = {1468-2834},
	shorttitle = {Comparing associations between frailty and mortality in hospitalised older adults with or without {COVID}-19 infection},
	doi = {10.1093/ageing/afaa167},
	abstract = {BACKGROUND: The aim of this study was to describe outcomes in hospitalised older people with different levels of frailty and COVID-19 infection.
METHODS: We undertook a single centre, retrospective cohort study examining COVID-19 related mortality using Electronic Health Records, for older people (65 and over) with frailty, hospitalised with or without COVID-19 infection. Baseline covariates included demographics, Early Warning Scores, Charlson Comorbidity Indices and frailty (Clinical Frailty Scale, CFS), linked to COVID-19 status.
FINDINGS: We analysed outcomes on 1,071 patients with COVID-19 test results; 285 (27\%) were positive for COVID-19.)The mean age at ED arrival was 79.7 and 49.4\% were female. All-cause mortality (by 30 days) rose from 9\% (not frail) through to 33\% (severely frail) in the COVID negative cohort but was around 60\% for all frailty categories in the COVID positive cohort. In adjusted analyses, the hazard ratio for death in those with COVID-19 compared to those without COVID-19 was 7.3, 95\% CI: 3.00, 18.0) with age, comorbidities and illness severity making small additional contributions.
INTERPRETATION: In this study frailty, measured using the Clinical Frailty Scale, appeared to make little incremental contribution to the hazard of dying in older people hospitalised with COVID-19 infection; illness severity and comorbidity had a modest association with the overall adjusted hazard of death, whereas confirmed COVID-19 infection dominated, with a seven-fold hazard for death.},
	language = {eng},
	journal = {Age and Ageing},
	author = {Owen, R.K. and Conroy, S.P. and Taub, N. and Jones, W. and Bryden, D. and Pareek, M. and Faull, C. and Abrams, K.R. and Davis, D. and Banerjee, J.},
	month = jul,
	year = {2020},
	keywords = {COVID-19, Cohort study, Frailty, older people},
}
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