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Beyond Chronologica...
Beyond Chronological Age : Frailty and Multimorbidity Predict In-Hospital Mortality in Patients With Coronavirus Disease 2019
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- Marengoni, Alessandra (author)
- Stockholms universitet,Centrum för forskning om äldre och åldrande (ARC), (tills m KI),University of Brescia, Italy
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Zucchelli, Alberto (author)
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- Vetrano, Davide Liborio (author)
- Karolinska Institutet,Stockholms universitet,Centrum för forskning om äldre och åldrande (ARC), (tills m KI),Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Italy; Università Cattolica del Sacro Cuore, Italy
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Armellini, Andrea (author)
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Botteri, Emanuele (author)
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Nicosia, Franco (author)
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Romanelli, Giuseppe (author)
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Beindorf, Eva Andrea (author)
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Giansiracusa, Paola (author)
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Garrafa, Emirena (author)
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Ferrucci, Luigi (author)
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- Fratiglioni, Laura (author)
- Karolinska Institutet,Stockholms universitet,Centrum för forskning om äldre och åldrande (ARC), (tills m KI)
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Bernabei, Roberto (author)
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Onder, Graziano (author)
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(creator_code:org_t)
- 2020-11-20
- 2021
- English.
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In: The journals of gerontology. Series A, Biological sciences and medical sciences. - : Oxford University Press (OUP). - 1079-5006 .- 1758-535X. ; 76:3, s. e38-e45
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Abstract
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- Background: We evaluated whether frailty and multimorbidity predict in-hospital mortality in patients with COVID-19 beyond chronological age.Method: A total of 165 patients admitted from March 8th to April 17th, 2020, with COVID-19 in an acute geriatric ward in Italy were included. Predisease frailty was assessed with the Clinical Frailty Scale (CFS). Multimorbidity was defined as the co-occurrence of >= 2 diseases in the same patient. The hazard ratio (HR) of in-hospital mortality as a function of CFS score and number of chronic diseases in the whole population and in those aged 70+ years were calculated.Results: Among the 165 patients, 112 were discharged, 11 were transferred to intensive care units, and 42 died. Patients who died were older (81.0 vs 65.2 years, p < .001), more frequently multimorbid (97.6 vs 52.8%; p < .001), and more likely frail (37.5 vs 4.1%; p < .001). Less than 2.0% of patients without multimorbidity and frailty, 28% of those with multimorbidity only, and 75% of those with both multimorbidity and frailty died. Each unitary increment in the CFS was associated with a higher risk of in-hospital death in the whole sample (HR = 1.3; 95% CI = 1.05-1.62) and in patients aged 70+ years (HR = 1.29; 95% CI = 1.04-1.62), whereas the number of chronic diseases was not significantly associated with higher risk of death. The CFS addition to age and sex increased mortality prediction by 9.4% in those aged 70+ years.Conclusions: Frailty identifies patients with COVID-19 at risk of in-hospital death independently of age. Multimorbidity contributes to prognosis because of the very low probability of death in its absence.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Geriatrik (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Geriatrics (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Anestesi och intensivvård (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Anesthesiology and Intensive Care (hsv//eng)
Keyword
- COVID-19
- Frailty
- In-hospital mortality
- Multimorbidity
Publication and Content Type
- ref (subject category)
- art (subject category)
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Marengoni, Aless ...
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Zucchelli, Alber ...
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Vetrano, Davide ...
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Armellini, Andre ...
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Botteri, Emanuel ...
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Nicosia, Franco
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Romanelli, Giuse ...
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Beindorf, Eva An ...
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Giansiracusa, Pa ...
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Garrafa, Emirena
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Ferrucci, Luigi
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Fratiglioni, Lau ...
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Bernabei, Robert ...
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Onder, Graziano
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Geriatrics
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Anesthesiology a ...
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Stockholm University
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Karolinska Institutet