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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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DOI (Published version): 10.1007/s41999-022-00668-8

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
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URI: https://cronfa.swan.ac.uk/Record/cronfa60326
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spelling 2023-01-05T12:30:39.6418384 v2 60326 2022-06-27 The association between frailty risk and COVID-19-associated all-mortality in hospitalised older people: a national cohort study 0d30aa00eef6528f763a1e1589f703ec 0000-0001-5977-376X Rhiannon Owen Rhiannon Owen true false 2022-06-27 MEDS 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. Journal Article European Geriatric Medicine 13 1149 1157 Springer Science and Business Media LLC 1878-7657 COVID-19; Frailty; Acute hospital outcomes 24 6 2022 2022-06-24 10.1007/s41999-022-00668-8 COLLEGE NANME Medical School COLLEGE CODE MEDS Swansea University Laia Maynou is funded by the Spanish Ministry of Science, Innovation and Universities (PID2019-104319RB-I00)’. 2023-01-05T12:30:39.6418384 2022-06-27T09:19:13.9067210 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medicine Laia Maynou 1 Rhiannon Owen 0000-0001-5977-376X 2 Rob Konstant-Hambling 3 Towhid Imam 4 Suzanne Arkill 5 Deborah Bertfield 6 Andrew Street 7 Keith R. Abrams 8 Simon Conroy 0000-0002-4306-6064 9 60326__24609__18d096fe609742839fd6c8594fd32ff6.pdf 60326.pdf 2022-07-15T10:30:09.6828611 Output 731066 application/pdf Version of Record true © The Author(s) 2022. This article is licensed under a Creative Commons Attribution 4.0 International License true eng http://creativecommons.org/licenses/by/4.0/
title The association between frailty risk and COVID-19-associated all-mortality in hospitalised older people: a national cohort study
spellingShingle The association between frailty risk and COVID-19-associated all-mortality in hospitalised older people: a national cohort study
Rhiannon Owen
title_short The association between frailty risk and COVID-19-associated all-mortality in hospitalised older people: a national cohort study
title_full The association between frailty risk and COVID-19-associated all-mortality in hospitalised older people: a national cohort study
title_fullStr The association between frailty risk and COVID-19-associated all-mortality in hospitalised older people: a national cohort study
title_full_unstemmed The association between frailty risk and COVID-19-associated all-mortality in hospitalised older people: a national cohort study
title_sort The association between frailty risk and COVID-19-associated all-mortality in hospitalised older people: a national cohort study
author_id_str_mv 0d30aa00eef6528f763a1e1589f703ec
author_id_fullname_str_mv 0d30aa00eef6528f763a1e1589f703ec_***_Rhiannon Owen
author Rhiannon Owen
author2 Laia Maynou
Rhiannon Owen
Rob Konstant-Hambling
Towhid Imam
Suzanne Arkill
Deborah Bertfield
Andrew Street
Keith R. Abrams
Simon Conroy
format Journal article
container_title European Geriatric Medicine
container_volume 13
container_start_page 1149
publishDate 2022
institution Swansea University
issn 1878-7657
doi_str_mv 10.1007/s41999-022-00668-8
publisher Springer Science and Business Media LLC
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Medicine{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Medicine
document_store_str 1
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description 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.
published_date 2022-06-24T02:25:20Z
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