Impact of Comorbidities and COVID-19 on the Survival Rate of Geriatric Patients Receiving Anesthesia Services: A Prospective Cohort Study in Indonesia (preprint)

Background: As life expectancy increases, the worldwide population aged 60 years and older increases year by year. Consequently, more older people receive medical attention, especially those who undergo surgery. In addition, the COVID-19 pandemic has had a global impact on elderly patients, especially those undergoing surgery. This study aims to describe the characteristics and analyze the survival rate of elderly patients who receive anesthesia services, especially those with comorbidities and COVID-19. Methods A prospective cohort study at 14 central hospitals in Indonesia analyzed 1621 elderly patients (67.1 ± 6.2 years old). The variables that were recorded included patient characteristics, comorbidities, the COVID-19 status, and the survival rate, including 30-day mortality. Results The 30-day mortality was 4.4%. The most comorbidity was hypertension (30.0). Patients with a Charlson's Comorbidity Index Score of 3-4 had a higher death rate (15.3%). The highest mortality rates were in the patients who had dementia, rheumatologic disease, liver disease, previous myocardial infarction, and diabetes with chronic complications as comorbidities. The percent of patients with COVID-19 who died was 26.6%. Patients with several comorbidities and COVID-19 had a lower survival rate than those without (log-rank p<0.05) Conclusion Approximately four in ten elderly patients receiving anesthesia died, and the percent increased when the patients had comorbidities and COVID-19.

Comorbidities and COVID-19 Status Influence the Survival Rate of Geriatric Patients in Intensive Care Units: a Prospective Cohort Study From the Indonesian Society of Anaesthesiology and Intensive Therapy (preprint)

Background: With the more advanced science in the field of medicine and disease management, the population of geriatric intensive care patients is increasing. The COVID-19 pandemic has impacted healthcare management around the globe, especially on critically-ill elderly patients. We aim to analyse the relationship between underlying illnesses, including COVID-19, and the survival rate of elderly patients who are treated in the intensive care setting. Methods: : We conducted a prospective cohort study at 14 teaching hospitals for Anaesthesiology and Intensive Therapy Education in Indonesia. We selected all subjects with 60 years of age or older in the period between February to May 2021. Variables recorded included subject characteristics, comorbidities, and COVID-19 status. Subjects were followed for 30-day mortality as an outcome. We analysed the data using Kaplan-Meier survival analysis. Results: : We recruited 982 elderly patients, and 728 subjects were in the final analysis (60.7% male; 68.0 ± 6.6 years old). The 30-day mortality was 38.6%. The top five comorbidities are hypertension (21.1%), diabetes (16.2%), moderate or severe renal disease (10.6%), congestive heart failure (9.2%), and cerebrovascular disease (9.1%). Subjects with Charlson's Comorbidity Index Score >5 experienced 66% death. Subjects with COVID-19 who died were 57.4%. Subjects with comorbidities and COVID-19 had lower survival rates than subjects without those conditions (p < 0.005). Conclusion: Approximately one in four elderly intensive care patients die, and the number is increasing with comorbidities and COVID-19 status.