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The association between frailty risk and COVID-19-associated all-mortality in hospitalised older people: a national cohort study

Laia Maynou, Rhiannon Owen Orcid Logo, Rob Konstant-Hambling, Towhid Imam, Suzanne Arkill, Deborah Bertfield, Andrew Street, Keith R. Abrams, Simon Conroy Orcid Logo

European Geriatric Medicine, Volume: 13, Pages: 1149 - 1157

Swansea University Author: Rhiannon Owen Orcid Logo

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Abstract

IntroductionFrailty has emerged as an important construct to support clinical decision-making during the COVID-19 pandemic. However, doubts remain related to methodological limitations of published studies.MethodsRetrospective cohort study of all people aged 75 + admitted to hospital in England betw...

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Published in: European Geriatric Medicine
ISSN: 1878-7657
Published: Springer Science and Business Media LLC 2022
Online Access: Check full text

URI: https://cronfa.swan.ac.uk/Record/cronfa60326
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Abstract: IntroductionFrailty has emerged as an important construct to support clinical decision-making during the COVID-19 pandemic. However, doubts remain related to methodological limitations of published studies.MethodsRetrospective cohort study of all people aged 75 + admitted to hospital in England between 1 March 2020 and 31 July 2021. COVID-19 and frailty risk were captured using International Classification of Disease-10 (ICD-10) diagnostic codes. We used the generalised gamma model to estimate accelerated failure time, reporting unadjusted and adjusted results.ResultsThe cohort comprised 103,561 individuals, mean age 84.1, around half female, 82% were White British with a median of two comorbidities. Frailty risk was distributed approximately 20% low risk and 40% each at intermediate or high risk. In the unadjusted survival plots, 28-day mortality was almost 50% for those with an ICD-10 code of U071 (COVID-19 virus identified), and 25–35% for those with U072 (COVID-19 virus not identified). In the adjusted analysis, the accelerated failure time estimates for those with intermediate and high frailty risk were 0.63 (95% CI 0.58–0.68) and 0.67 (95% CI 0.62–0.72) fewer days alive respectively compared to those with low frailty risk with an ICD-10 diagnosis of U072 (reference category).ConclusionIn older people with confirmed COVID-19, both intermediate and high frailty risk were associated with reduced survival compared to those with low frailty risk.
Keywords: COVID-19; Frailty; Acute hospital outcomes
College: Faculty of Medicine, Health and Life Sciences
Funders: Laia Maynou is funded by the Spanish Ministry of Science, Innovation and Universities (PID2019-104319RB-I00)’.
Start Page: 1149
End Page: 1157