Frailty is associated with in-hospital mortality in older hospitalised COVID-19 patients in the Netherlands: the COVID-OLD study

BackgroundDuring the first wave of the COVID-19 pandemic older patients had an increased risk of hospitalisation and death. Reports on the association of frailty with poor outcome have been conflicting.ObjectiveThe aim of the present study was to investigate the independent association between frailty and in-hospital mortality in older hospitalised COVID-19 patients in the Netherlands.MethodsThis was a multi-centre retrospective cohort study in 15 hospitals in the Netherlands, including all patients aged ≥70 years, who were hospitalised with clinically confirmed COVID-19 between February and May 2020. Data were collected on demographics, co-morbidity, disease severity and Clinical Frailty Scale (CFS). Primary outcome was in-hospital mortality.ResultsA total of 1,376 patients were included (median age 78 years (IQR 74-84), 60% male). In total, 499 (38%) patients died during hospital admission. Parameters indicating presence of frailty (CFS 6-9) were associated with more co-morbidities, shorter symptom duration upon presentation (median 4 vs. 7 days), lower oxygen demand and lower levels of CRP. In multivariable analyses, the CFS was independently associated with in-hospital mortality: compared to patients with CFS 1-3, patients with CFS 4-5 had a two times higher risk (odds ratio (OR) 2.0 (95%CI 1.3-3.0) and patients with CFS 6-9 had a three times higher risk of in-hospital mortality (OR 2.8 (95%CI 1.8-4.3)).ConclusionsThe in-hospital mortality of older hospitalised COVID-19 patients in the Netherlands was 38%. Frailty was independently associated with higher in-hospital mortality, even though COVID-19 patients with frailty presented earlier to the hospital with less severe symptoms.Pathophysiology, epidemiology and therapy of agein

A multi‐scale study of the dominant catchment characteristics impacting low‐flow metrics

Low flows can impact water use and instream ecology. Therefore, reliable predictions of low-flow metrics are crucial. In this study, we assess which catchment characteristics (climate, topography, geology and landcover) can explain the spatial variability of low-flow metrics at two different scales: the regional scale and the small headwater catchment scale. For the regional-scale analysis, we calculated the mean 7-day annual minimum flow (qmin), the mean of the flow that is exceeded 95% of the year (q95), and the master recession constant (C) for 280 independent gauging stations across the Swiss Plateau and the Swiss Alps for the 2000–2018 period. We assessed the relation between 44 catchment characteristics and the three low-flow metrics based on correlation analysis and a random forest model. Low-flow magnitudes across the Swiss Plateau were positively correlated with the fraction of the area covered by sandstone bedrock or alluvium, and with the area that has a slope between 10° and 30°. Across the Swiss Alps, low-flow magnitudes were positively correlated with the fraction of area with slopes between 30° and 60°, and the area with glacial deposits and debris cover. There was good agreement between observations and predictions by the random forest regression model with the top 11 catchment characteristics for both regions: for 80% of the Swiss Plateau catchments and 60% of the Swiss Alpine catchments, we could predict the three low-flow metrics within an error of 30%. The residuals of the regression model, however, varied across short distances, suggesting that local catchment characteristics affect the variability of low-flow metrics. For the local-scale headwater catchments, we conducted 1-day snapshot field campaigns in 16 catchments during low-flow periods in 2015 and 2016. The measurements in these sub-catchments also showed that areas with sandstone bedrock and a good storage-to-river connectivity had above average low-flow magnitudes. Including knowledge on local catchment characteristics may help to improve regional low-flow predictions, however, not all local catchment characteristics were useful descriptors at larger scales.ISSN:0885-6087ISSN:1099-108

Entwicklung von Prozessmodellen zum Randschichthaerten von Staehlen mittels Elektronenstrahlen Abschlussbericht

Available from TIB Hannover: F98B1159 / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekSIGLEDEGerman

Fracture behaviour of ledeburitic tool steels under static loading Draft final report

Summary in EnglishSIGLEAvailable from TIB Hannover: F98B1002 / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekDEGerman

Indiscriminate friendliness in foster children: Associations with attachment security, foster parents’ sensitivity, and child inhibitory control

Education and Child Studie