Geriatrics-focused indicators predict mortality more than age in older adults hospitalized with COVID-19.
BMC Geriatr
; 21(1): 554, 2021 10 14.
Article
in English
| MEDLINE | ID: covidwho-1468047
ABSTRACT
BACKGROUND:
Age has been implicated as the main risk factor for COVID-19-related mortality. Our objective was to utilize administrative data to build an explanatory model accounting for geriatrics-focused indicators to predict mortality in hospitalized older adults with COVID-19.METHODS:
Retrospective cohort study of adults age 65 and older (N = 4783) hospitalized with COVID-19 in the greater New York metropolitan area between 3/1/20-4/20/20. Data included patient demographics and clinical presentation. Stepwise logistic regression with Akaike Information Criterion minimization was used.RESULTS:
The average age was 77.4 (SD = 8.4), 55.9% were male, 20.3% were African American, and 15.0% were Hispanic. In multivariable analysis, male sex (adjusted odds ration (adjOR) = 1.06, 95% CI1.03-1.09); Asian race (adjOR = 1.08, CI1.03-1.13); history of chronic kidney disease (adjOR = 1.05, CI1.01-1.09) and interstitial lung disease (adjOR = 1.35, CI1.28-1.42); low or normal body mass index (adjOR1.03, CI1.00-1.07); higher comorbidity index (adjOR = 1.01, CI1.01-1.02); admission from a facility (adjOR = 1.14, CI1.09-1.20); and mechanical ventilation (adjOR = 1.52, CI1.43-1.62) were associated with mortality. While age was not an independent predictor of mortality, increasing age (centered at 65) interacted with hypertension (adjOR = 1.02, CI0.98-1.07, reducing by a factor of 0.96 every 10 years); early Do-Not-Resuscitate (DNR, life-sustaining treatment preferences) (adjOR = 1.38, CI1.22-1.57, reducing by a factor of 0.92 every 10 years); and severe illness on admission (at 65, adjOR = 1.47, CI1.40-1.54, reducing by a factor of 0.96 every 10 years).CONCLUSION:
Our findings highlight that residence prior to admission, early DNR, and acute illness severity are important predictors of mortality in hospitalized older adults with COVID-19. Readily available administrative geriatrics-focused indicators that go beyond age can be utilized when considering prognosis.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
COVID-19
/
Geriatrics
Type of study:
Cohort study
/
Observational study
/
Prognostic study
Limits:
Aged
/
Humans
/
Male
Language:
English
Journal:
BMC Geriatr
Journal subject:
Geriatrics
Year:
2021
Document Type:
Article
Affiliation country:
S12877-021-02527-W
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