Rapid Assessment at Hospital Admission of Mortality Risk From COVID-19: The Role of Functional Status.
J Am Med Dir Assoc
; 21(12): 1798-1802.e2, 2020 12.
Article
in English
| MEDLINE | ID: covidwho-838445
ABSTRACT
OBJECTIVE:
To evaluate the role of functional status along with other used clinical factors on the occurrence of death in patients hospitalized with COVID-19.DESIGN:
Prospective cohort study.SETTING:
Public university hospital (Madrid). PARTICIPANTS ANDMETHODS:
A total of 375 consecutive patients with COVID-19 infection, admitted to a Public University Hospital (Madrid) between March 1 and March 31, 2020, were included in the Prospective Cohort study. Death was the main outcome. The main variable was disability in activities of daily living (ADL) assessed with the Barthel Index. Covariates included sex, age, severity index (Quick Sequential Organ Failure Assessment, qSOFA), polypharmacy (≥5 drugs in the month before admission), and comorbidity (≥3 diseases). Multivariable logistic regression was used to identify risk factors for adverse outcomes. Estimated model coefficients served to calculate the expected probability of death for a selected combination of 5 variables Barthel Index, sex, age, comorbidities, and severity index (qSOFA).RESULTS:
Mean age was 66 years (standard deviation 15.33), and there were 207 (55%) men. Seventy-four patients died (19.8%). Mortality was associated with low Barthel Index (odds ratio per 5-point decrease 1.11, 95% confidence interval 1.03-1.20), male sex (0.23, 0.11-0.47), age (1.07, 1.03-1.10), and comorbidity (2.15, 1.08-4.30) but not with qSOFA (1.29, 0.87-1.93) or polypharmacy (1.54, 0.77-3.08). Calculated mortality risk ranged from 0 to 0.78. CONCLUSIONS AND IMPLICATIONS Functional status predicts death in hospitalized patients with COVID-19. Combination of 5 variables allows to predict individual probability of death. These findings provide useful information for the decision-making process and management of patients.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Functional Status
/
COVID-19
/
Hospitalization
Type of study:
Cohort study
/
Experimental Studies
/
Observational study
/
Prognostic study
Limits:
Aged
/
Female
/
Humans
/
Male
Country/Region as subject:
Europa
Language:
English
Journal:
J Am Med Dir Assoc
Journal subject:
History of Medicine
/
Medicine
Year:
2020
Document Type:
Article
Affiliation country:
J.jamda.2020.10.002
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