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Frailty important predictor of mortality in elderly with COVID 19, finds study
A recently published study in the International Journal of Infectious Diseases,has suggested that higher age, chronic kidney disease and previous stroke significantly contribute to a fatal outcome in hospitalized patients with COVID-19. The team of researchers further highlighted that in patients aged 65 years and older,Clinical Frailty Scale (CFS) was the strongest prognostic factor for mortality.
In the rise of the pandemic, older and frail patients with rapid progress of respiratory failure, questions regarding optimal clinical management and limitations of life sustaining treatment have been raised over and again. In the light of the difficulty to make well-grounded decisions on advanced life support treatment for this patient group, researchers under Sara Tehrani, from the Karolinska Institutet, Department of Clinical Sciences, Sweden, sought to bridge this gap.
This study focused on the baseline characteristics and clinical outcome of 255 in-patients with COVID-19 admitted to a University Hospital in Stockholm between early March and late April of 2020 with a 60-day follow-up. Patient data was extracted manually from the electronic health records using a standardized protocol.
The main aim was to investigate the demographics, co-morbidities and death rate in hospitalized patients with confirmed COVID-19. In addition, the team went forward with a hypothesis that functional status, according to Clinical Frailty Scale (CFS), in patients aged 65 years and older is a better predictor of poor outcome than age and co-morbidities.
On data analysis, the following key facts emerged.
- The age of the study population ranged between 20 and 103 years, (mean age was 66 ± 17 years).
- Hypertension, diabetes mellitus and obesity were the three most prevalent comorbidities. At the 60-day follow-up, 70 patients (27%) had died.
- In multivariate analyses, age, chronic kidney disease and previous stroke were associated with death.
- Most fatal cases (90%) occurred in older patients. Among the older patients, CFS was the only predictor of death in multivariate analyses.
Observing the results the team highlighted some facts.
- Male predominance and obesity is commonly found in hospitalized COVID-19 patients.
- Chronic kidney disease and previous stroke are independent risk factors for death.
- Clinical frailty scale is the strongest predictor for mortality among older patients.
For the full article follow the link: DOI: https://doi.org/10.1016/j.ijid.2020.10.071
Primary source: International Journal of Infectious Diseases
Dr Satabdi Saha (BDS, MDS) is a practicing pediatric dentist with a keen interest in new medical researches and updates. She has completed her BDS from North Bengal Dental College ,Darjeeling. Then she went on to secure an ALL INDIA NEET PG rank and completed her MDS from the first dental college in the country – Dr R. Ahmed Dental College and Hospital. She is currently attached to The Marwari Relief Society Hospital as a consultant along with private practice of 2 years. She has published scientific papers in national and international journals. Her strong passion of sharing knowledge with the medical fraternity has motivated her to be a part of Medical Dialogues.
Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751