The impact of frailty on survival in elderly intensive care patients with COVID-19: the COVIP study.

Details

Serval ID
serval:BIB_B11E56AF398C
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
The impact of frailty on survival in elderly intensive care patients with COVID-19: the COVIP study.
Journal
Critical care
Author(s)
Jung C., Flaatten H., Fjølner J., Bruno R.R., Wernly B., Artigas A., Bollen Pinto B., Schefold J.C., Wolff G., Kelm M., Beil M., Sviri S., van Heerden P.V., Szczeklik W., Czuczwar M., Elhadi M., Joannidis M., Oeyen S., Zafeiridis T., Marsh B., Andersen F.H., Moreno R., Cecconi M., Leaver S., Boumendil A., De Lange D.W., Guidet B.
Working group(s)
COVIP study group
Contributor(s)
Flaatten H., Wernly B., Artigas A., Beil M., Sviri S., van Heerden P.V., Szczeklik W., Elhadi M., Zafeiridis T., Moreno R., Cecconi M., Boumendil A., Abosheaishaa H.M., Abualqumboz EMY, Ahmed A.K., Ahmed H., Aidoni Z., Aldecoa C., Alexandru N., Ali YKNM, Al-Sadawi M., Andersen K., Andersen F.H., Assis R., Azab M.A., Azzam A.Y., Badawy M.R., Balleby I.R., Barth E., Barth E., Ben-HAmouda N., Besch G., Besset S., Bjerregaard A.T., Brix H., Bruno R.R., Brushoej J., Bundgaard H., Burtin P., Caillard A., Canas-Perez I., Charron C., Chrisanthopoulou E., Comellini V., Cornet A., Cubero P.J., Czuczwar M., Dauger S., Diaz-Rodriguez C., Dieperink W., Dindane Z., Djibré M., Dormans T., Dullenkopf A., Dumas G., Elgazzar Y.A., Eller P., Elsaka A., Evers M., Faltlhauser A., Ferreira A.F., Fjølner J., Fleury Y., Galbois A., Garcon P., Garnier M., Gawda R., Ghannam A., Goebel U., Gomà G., Goncalves B., Gordinho A., Groenendijk M., Guerot E., Guidet B., Gurjar M., Haake H., Haas L., Habib A.A., Hahn M., Hansen M.A., Hilles MMY, Hussein AARM, Iglesias D., Joannidis M., Jung C., Jurcisin I., Kabitz H.J., Kelm M., Kindgen-Milles D., Klimkiewicz J., Kuhn K.F., Kunstein A., Kurt M., De Lange D.W., Leaver S., Lutz M., Mahmoodpoor A., Maizel J., Marin N., Marsh B., Megarbane B., Mesotten D., Meybohm P., Meyer C., Mira A.P., Namendys-Silva S.A., Nedergaard H.K., Nseir S., Oeyen S., Olasveengen T., Oliveira AIP, Oziel J., Papadogoulas A., Perez-Torres D., Bollen Pinto B., Piton G., Plantefeve G., Poerner T., Priego J., Rabha A., Randerath W., Raphaelen J.H., Reper P., Rigaud J.P., Rivera S.A., Roberti A., Romundstad L., Rovina N., Salah R., Saleh M., Sancho S., de Lurdes Campos Santos M., Santos H., Schaller S., Schefold J.C., Schuster M., Shala G., Sjøbø B., Steiner S., Strietzel H.F., Sviri S., Swinnen W., Tamayo-Lomas L., Tharwat S., Tomasa T., Uhrenholt S., Vaissiere M., Valent A., Valette X., Vanderlinden T., Vázquez E.M., Villamayor M.I., Villefrance M., Voigt I., Wassim K., Welte M., Wolff G., Wollborn J., Zalba-Etayo B., Zegers M.
ISSN
1466-609X (Electronic)
ISSN-L
1364-8535
Publication state
Published
Issued date
19/04/2021
Peer-reviewed
Oui
Volume
25
Number
1
Pages
149
Language
english
Notes
Publication types: Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
Publication Status: epublish
Abstract
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: NCT04321265 , registered 19 March 2020.
Keywords
Aged, Aged, 80 and over, COVID-19/mortality, COVID-19/therapy, Critical Care, Female, Frail Elderly/statistics & numerical data, Frailty/mortality, Humans, Male, Prognosis, Prospective Studies, Survival Analysis, COVID-19, Elderly, Frailty, Outcome, Pandemia
Pubmed
Open Access
Yes
Create date
28/04/2021 9:13
Last modification date
29/04/2021 6:37
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