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Senior-COVID-Rea Cohort Study: A Geriatric Prediction Model of 30-day Mortality in Patients Aged over 60 Years in ICU for Severe COVID-19.
Falandry, Claire; Bitker, Laurent; Abraham, Paul; Subtil, Fabien; Collange, Vincent; Balança, Baptiste; Haïne, Max; Guichon, Céline; Leroy, Christophe; Simon, Marie; Malapert, Amélie; Pialat, Jean-Baptiste; Jallades, Laurent; Lepape, Alain; Friggeri, Arnaud; Thiolliere, Fabrice.
  • Falandry C; 1Hospices Civils de Lyon, Service de Gériatrie, Centre Hospitalier Lyon Sud, Pierre-Bénite, France.
  • Bitker L; 2Université de Lyon, Laboratoire CarMeN, Inserm U1060, INRA U1397, Université Claude Bernard Lyon 1, INSA Lyon, Charles Mérieux Medical School, Pierre-Bénite, France.
  • Abraham P; 3Hospices Civils de Lyon, Service de Réanimation Médicale, Hôpital de La Croix Rousse, Lyon, France.
  • Subtil F; 4Université de Lyon, CREATIS INSERM 1044 CNRS 5220, Villeurbanne, France.
  • Collange V; 5Hospices Civils de Lyon, Département d'anesthésie et reanimation médicale, Hôpital Edouard Herriot, Lyon, France.
  • Balança B; 6Université de Lyon, CNRS, UMR5558, Laboratoire de Biométrie et Biologie Evolutive, Université Claude Bernard Lyon 1, Villeurbanne, France.
  • Haïne M; 7Hospices Civils de Lyon, Service de Biostatistique, Lyon, France.
  • Guichon C; 8Medipole Lyon-Villeurbanne, Département anesthésie réanimation, Villeurbanne, France.
  • Leroy C; 9Hospices Civils de Lyon, Département of d'Anesthésie Réanimation Neurologique, Hôpital Wertheimer, Bron, France.
  • Simon M; 10Hôpital Pierre Wertheimer; Université de Lyon, Inserm U1028, CNRS UMR 5292, Lyon Neuroscience Research Centre, Team TIGER, Bron, France.
  • Malapert A; 11Hôpital Nord-Ouest, Service de Gériatrie, Gleizé, France.
  • Pialat JB; 12Hospices Civils de Lyon, Service de réanimation, Centre hospitalier universitaire de la Croix Rousse, Lyon, France.
  • Jallades L; 13Université de Lyon, Lyon, France.
  • Lepape A; 14Centre Hospitalier Emile Roux, Service de réanimation, Le Puy-en-Velay, France.
  • Friggeri A; 15Hospices Civils de Lyon, Service de Médecine Intensive-Réanimation Médicale, Hôpital Edouard Herriot, Lyon, France.
  • Thiolliere F; 16Hospices Civils de Lyon, Plateforme Transversale de Recherche de l'ICHCL, Pierre-Bénite, France.
Aging Dis ; 13(2): 614-623, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1856376
ABSTRACT
The SARS-COV2 pandemic induces tensions on health systems and ethical dilemmas. Practitioners need help tools to define patients not candidate for ICU admission. A multicentre observational study was performed to evaluate the impact of age and geriatric parameters on 30-day mortality in patients aged ≥60 years of age. Patients or next of kin were asked to answer a phone questionnaire assessing geriatric covariates 1 month before ICU admission. Among 290 screened patients, 231 were included between March 7 and May 7, 2020. In univariate, factors associated with lower 30-day survival were age (per 10 years increase; OR 3.43, [95%CI 2.13-5.53]), ≥3 CIRS-G grade ≥2 comorbidities (OR 2.49 [95%CI 1.36-4.56]), impaired ADL, (OR 4.86 [95%CI 2.44-9.72]), impaired IADL8 (OR 6.33 [95%CI 3.31-12.10], p<0.001), frailty according to the Fried score (OR 4.33 [95%CI 2.03-9.24]) or the CFS ≥5 (OR 3.79 [95%CI 1.76-8.15]), 6-month fall history (OR 3.46 [95%CI 1.58-7.63]). The final multivariate model included age (per 10 years increase; 2.94 [95%CI1.78-5.04], p<0.001) and impaired IADL8 (OR 5.69 [95%CI 2.90-11.47], p<0.001)). Considered as continuous variables, the model led to an AUC of 0.78 [95% CI 0.72, 0.85]. Age and IADL8 provide independent prognostic factors for 30-day mortality in the considered population. Considering a risk of death exceeding 80% (82.6% [95%CI 61.2% - 95.0%]), patients aged over 80 years with at least 1 IADL impairment appear as poor candidates for ICU admission.
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Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Language: English Journal: Aging Dis Year: 2022 Document Type: Article Affiliation country: AD.2021.1004

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Language: English Journal: Aging Dis Year: 2022 Document Type: Article Affiliation country: AD.2021.1004