1. The impact of frailty on survival in elderly intensive care patients with COVID-19: the COVIP study
- Author
-
Christian Jung, Hans Flaatten, Jesper Fjølner, Raphael Romano Bruno, Bernhard Wernly, Antonio Artigas, Bernardo Bollen Pinto, Joerg C. Schefold, Georg Wolff, Malte Kelm, Michael Beil, Sviri Sigal, Peter Vernon van Heerden, Wojciech Szczeklik, Miroslaw Czuczwar, Muhammed Elhadi, Michael Joannidis, Sandra Oeyen, Tilemachos Zafeiridis, Brian Marsh, Finn H. Andersen, Rui Moreno, Maurizio Cecconi, Susannah Leaver, Ariane Boumendil, Dylan W. De Lange, Bertrand Guidet, COVIP study group, Flaatten, H., Wernly, B., Artigas, A., Beil, M., Sviri, S., van Heerden, P.V., Szczeklik, W., Elhadi, M., Zafeiridis, T., Moreno, R., Cecconi, M., Boumendil, A., Abosheaishaa, H.M., Abualqumboz, EMY, Ahmed, A.K., Ahmed, H., Aidoni, Z., Aldecoa, C., Alexandru, N., Ali, YKNM, Al-Sadawi, M., Andersen, K., Andersen, F.H., Assis, R., Azab, M.A., Azzam, A.Y., Badawy, M.R., Balleby, I.R., Barth, E., Ben-HAmouda, N., Besch, G., Besset, S., Bjerregaard, A.T., Brix, H., Bruno, R.R., Brushoej, J., Bundgaard, H., Burtin, P., Caillard, A., Canas-Perez, I., Charron, C., Chrisanthopoulou, E., Comellini, V., Cornet, A., Cubero, P.J., Czuczwar, M., Dauger, S., Diaz-Rodriguez, C., Dieperink, W., Dindane, Z., Djibré, M., Dormans, T., Dullenkopf, A., Dumas, G., Elgazzar, Y.A., Eller, P., Elsaka, A., Evers, M., Faltlhauser, A., Ferreira, A.F., Fjølner, J., Fleury, Y., Galbois, A., Garcon, P., Garnier, M., Gawda, R., Ghannam, A., Goebel, U., Gomà, G., Goncalves, B., Gordinho, A., Groenendijk, M., Guerot, E., Guidet, B., Gurjar, M., Haake, H., Haas, L., Habib, A.A., Hahn, M., Hansen, M.A., Hilles, MMY, Hussein, AARM, Iglesias, D., Joannidis, M., Jung, C., Jurcisin, I., Kabitz, H.J., Kelm, M., Kindgen-Milles, D., Klimkiewicz, J., Kuhn, K.F., Kunstein, A., Kurt, M., De Lange, D.W., Leaver, S., Lutz, M., Mahmoodpoor, A., Maizel, J., Marin, N., Marsh, B., Megarbane, B., Mesotten, D., Meybohm, P., Meyer, C., Mira, A.P., Namendys-Silva, S.A., Nedergaard, H.K., Nseir, S., Oeyen, S., Olasveengen, T., Oliveira, AIP, Oziel, J., Papadogoulas, A., Perez-Torres, D., Bollen Pinto, B., Piton, G., Plantefeve, G., Poerner, T., Priego, J., Rabha, A., Randerath, W., Raphaelen, J.H., Reper, P., Rigaud, J.P., Rivera, S.A., Roberti, A., Romundstad, L., Rovina, N., Salah, R., Saleh, M., Sancho, S., de Lurdes Campos Santos, M., Santos, H., Schaller, S., Schefold, J.C., Schuster, M., Shala, G., Sjøbø, B., Steiner, S., Strietzel, H.F., Swinnen, W., Tamayo-Lomas, L., Tharwat, S., Tomasa, T., Uhrenholt, S., Vaissiere, M., Valent, A., Valette, X., Vanderlinden, T., Vázquez, E.M., Villamayor, M.I., Villefrance, M., Voigt, I., Wassim, K., Welte, M., Wolff, G., Wollborn, J., Zalba-Etayo, B., Zegers, M., and Critical care, Anesthesiology, Peri-operative and Emergency medicine (CAPE)
- Subjects
Male ,Aged, 80 and over ,Pandemia ,COVID-19/mortality ,Frailty ,Critical Care ,Frail Elderly/statistics & numerical data ,COVID-19 ,610 Medicine & health ,Prognosis ,Survival Analysis ,Elderly ,Frailty/mortality ,Humans ,Female ,Prospective Studies ,Outcome ,Aged ,COVID-19/therapy - Abstract
BackgroundThe COVID-19 pandemic has led highly developed healthcare systems to the brink of collapse due to the large numbers of patients being admitted into hospitals. One of the potential prognostic indicators in patients with COVID-19 is frailty. The degree of frailty could be used to assist both the triage into intensive care, and decisions regarding treatment limitations. Our study sought to determine the interaction of frailty and age in elderly COVID-19 ICU patients.MethodsA prospective multi-centre study of COVID-19 patients ≥ 70 years admitted to intensive care in 138 ICUs from 28 countries was conducted. The primary endpoint was 30-day mortality. Frailty was assessed using the Clinical Frailty Scale (CFS). Additionally, comorbidities, management strategies and treatment limitations were recorded.ResultsThe study included 1346 patients (28% female) with a median age of 75 years (IQR 72-78, range 70-96), 16.3% were older than 80 years and 21% of the patients were frail. The overall survival at 30 days was 59% (95%CI 56-62), with 66% (63-69) in fit, 53% (47-61) in vulnerable and 41% (35-47) in frail patients (pConclusionFrailty provides relevant prognostic information in elderly COVID-19 patients in addition to age and comorbidities.
- Published
- 2021
- Full Text
- View/download PDF