Age and frailty are independently associated with increased COVID-19 mortality and increased care needs in survivors: results of an international multi-centre study

INTRODUCTION: Increased mortality has been demonstrated in older adults with COVID-19, but the effect of frailty has been unclear.METHODS: This multi-centre cohort study involved patients aged 18years and older hospitalised with COVID-19, using routinely collected data. We used Cox regression analysis to assess the impact of age, frailty, and delirium on the risk of inpatient mortality, adjusting for sex, illness severity, inflammation, and co-morbidities. We used ordinal logistic regression analysis to assess the impact of age, Clinical Frailty Scale (CFS), and delirium on risk of increased care requirements on discharge, adjusting for the same variables.RESULTS: Data from 5,711 patients from 55 hospitals in 12 countries were included (median age 74, IQR 54-83; 55.2% male). The risk of death increased independently with increasing age (>80 vs 18-49: HR 3.57, CI 2.54-5.02), frailty (CFS 8 vs 1-3: HR 3.03, CI 2.29-4.00) inflammation, renal disease, cardiovascular disease, and cancer, but not delirium. Age, frailty (CFS 7 vs 1-3: OR 7.00, CI 5.27-9.32), delirium, dementia, and mental health diagnoses were all associated with increased risk of higher care needs on discharge. The likelihood of adverse outcomes increased across all grades of CFS from 4 to 9.CONCLUSIONS: Age and frailty are independently associated with adverse outcomes in COVID-19. Risk of increased care needs was also increased in survivors of COVID-19 with frailty or older age

Abstract 15313: Analysis of Survival in Octogenarian and Nonagenarian Patients Treated With Primary Percutaneous Coronary Intervention for ST Elevation Myocardial Infarction

Introduction: With advancement in interventional cardiology an increase in the number of percutaneous coronary intervention (PCI) procedures has been noted in the elderly. However, the post procedure complication and mortality remain a challenge for the physicians. This study aimed to estimate the survival among men and women above 80 years of age who undergo primary PCI for treatment of ST elevation myocardial infarction. Methods: We analyzed the data collected prospectively from our cardiac center. The patients were followed up over 10 years. Most patient received stents followed by anti-platelet drugs and preventive measures to avoid further cardiac event. Kaplan Meier curves were generated to study survival post PCI (SPSS v2.2). Survival curves were developed to determine the influence of age, sex, type of stent and degree of coronary flow (TIMI 0-3) on post procedure survival. Results: From 2010 to 2019, total 502 patients &gt;80 years received PCI (282 males, 218 females). The median survival in the male and female population were 2.16 yrs. (95% CI 1.66 - 2.66) and 2.36 yrs. (95% CI 1.72-2.99)(P= 0.18). Significant difference of around 1 year (2.7 yrs. octogenarian vs 1.6 yrs. nonagenarian, p&lt;0.001, see figure 1) was found in post PCI survival between octogenarian and nonagenarian. However, the survival was longer in case of Bare metal stents (BMS)(n= 113) as compared to Drug eluting stents(DES)(n= 274) (2.7 yrs. vs. 2.0yr, p&lt;0.001). Similarly, post procedure TIMI flow analysis shows maximum survival in TIMI 3 followed by TIMI 2 and TIMI 1 ensuring the significance of TIMI grade flow. Conclusions: Our results demonstrate that PPCI in elderly patients have a better outcome and longer survival in octogenarians than nonagenarians. Similarly, use of BMS could be considered over DES in population above 80 years of age irrespective of gender. No difference in post PCI survival in male and female population. </jats:p

Age and frailty are independently associated with increased COVID-19 mortality and increased care needs in survivors: results of an international multi-centre study

Abstract Introduction Increased mortality has been demonstrated in older adults with coronavirus disease 2019 (COVID-19), but the effect of frailty has been unclear. Methods This multi-centre cohort study involved patients aged 18 years and older hospitalised with COVID-19, using routinely collected data. We used Cox regression analysis to assess the impact of age, frailty and delirium on the risk of inpatient mortality, adjusting for sex, illness severity, inflammation and co-morbidities. We used ordinal logistic regression analysis to assess the impact of age, Clinical Frailty Scale (CFS) and delirium on risk of increased care requirements on discharge, adjusting for the same variables. Results Data from 5,711 patients from 55 hospitals in 12 countries were included (median age 74, interquartile range [IQR] 54–83; 55.2% male). The risk of death increased independently with increasing age (&amp;gt;80 versus 18–49: hazard ratio [HR] 3.57, confidence interval [CI] 2.54–5.02), frailty (CFS 8 versus 1–3: HR 3.03, CI 2.29–4.00) inflammation, renal disease, cardiovascular disease and cancer, but not delirium. Age, frailty (CFS 7 versus 1–3: odds ratio 7.00, CI 5.27–9.32), delirium, dementia and mental health diagnoses were all associated with increased risk of higher care needs on discharge. The likelihood of adverse outcomes increased across all grades of CFS from 4 to 9. Conclusion Age and frailty are independently associated with adverse outcomes in COVID-19. Risk of increased care needs was also increased in survivors of COVID-19 with frailty or older age. </jats:sec

Age and frailty are independently associated with increased COVID-19 mortality and increased care needs in survivors: results of an international multi-centre study

Introduction: Increased mortality has been demonstrated in older adults with coronavirus disease 2019 (COVID-19), but the effect of frailty has been unclear. Methods: This multi-centre cohort study involved patients aged 18 years and older hospitalised with COVID-19, using routinely collected data. We used Cox regression analysis to assess the impact of age, frailty and delirium on the risk of inpatient mortality, adjusting for sex, illness severity, inflammation and co-morbidities. We used ordinal logistic regression analysis to assess the impact of age, Clinical Frailty Scale (CFS) and delirium on risk of increased care requirements on discharge, adjusting for the same variables. Results: Data from 5,711 patients from 55 hospitals in 12 countries were included (median age 74, interquartile range [IQR] 54–83; 55.2% male). The risk of death increased independently with increasing age (>80 versus 18–49: hazard ratio [HR] 3.57, confidence interval [CI] 2.54–5.02), frailty (CFS 8 versus 1–3: HR 3.03, CI 2.29–4.00) inflammation, renal disease, cardiovascular disease and cancer, but not delirium. Age, frailty (CFS 7 versus 1–3: odds ratio 7.00, CI 5.27–9.32), delirium, dementia and mental health diagnoses were all associated with increased risk of higher care needs on discharge. The likelihood of adverse outcomes increased across all grades of CFS from 4 to 9. Conclusion: Age and frailty are independently associated with adverse outcomes in COVID-19. Risk of increased care needs was also increased in survivors of COVID-19 with frailty or older age.</p