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

Maynou, Laia; Owen, Rhiannon; Konstant-Hambling, Rob; Imam, Towhid; Arkill, Suzanne; Bertfield, Deborah; Street, Andrew; ... Conroy, Simon; + view all (2022) The association between frailty risk and COVID-19-associated all-mortality in hospitalised older people: a national cohort study. European Geriatric Medicine 10.1007/s41999-022-00668-8. (In press). Green open access

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Abstract

Introduction: Frailty 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. / Methods: Retrospective 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. / Results: The 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). / Conclusion: In older people with confirmed COVID-19, both intermediate and high frailty risk were associated with reduced survival compared to those with low frailty risk.

Type: Article
Title: The association between frailty risk and COVID-19-associated all-mortality in hospitalised older people: a national cohort study
Location: Switzerland
Open access status: An open access version is available from UCL Discovery
DOI: 10.1007/s41999-022-00668-8
Publisher version: https://doi.org/10.1007/s41999-022-00668-8
Language: English
Additional information: This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
Keywords: COVID-19, Frailty, Acute hospital outcomes
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
URI: https://discovery.ucl.ac.uk/id/eprint/10153472
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