Department of Medicine, Federal University of São Carlos (UFSCar), São Carlos, Brazil.
Department of Gerontology, Federal University of São Carlos (UFSCar), São Carlos, Brazil.
Geriatr Nurs. 2021 Sep-Oct;42(5):1024-1028. doi: 10.1016/j.gerinurse.2021.06.011. Epub 2021 Jun 19.
We evaluated whether comorbidities predict disease severity and mortality in a cohort of 147 older adults with COVID-19. Patients were divided into three groups according to the Charlson Comorbidity Index (CCI) score. Groups 2 (CCI 4 - 5) and 3 (CCI ≥ 6) had higher 30-day mortality rate as compared to group 1 (CCI ≤ 3). Cox regression showed that even after adding sex, National Early Warning Score (NEWS) 2 score and the need for intensive care unit admission to the model, no significant changes were found in the mortality risk predicted by the CCI score, showing that chronic pathologies are key determinants of short-term survival in COVID-19. This work is important for the geriatric nursing field as it demonstrates that alternative approaches for clinical decision-making that consider the comorbidities, rather than only chronological age, can be especially significant for the management of COVID-19 patients' hospitalization.
我们评估了共病是否可预测 147 名 COVID-19 老年患者队列中的疾病严重程度和死亡率。根据 Charlson 合并症指数 (CCI) 评分,患者被分为三组。与第 1 组(CCI≤3)相比,第 2 组(CCI=4-5)和第 3 组(CCI≥6)的 30 天死亡率更高。Cox 回归显示,即使在向模型中添加性别、国家早期预警评分 (NEWS) 2 评分和需要入住重症监护病房后,CCI 评分预测的死亡率风险也没有显著变化,这表明慢性病理是 COVID-19 短期生存的关键决定因素。这项工作对老年护理领域很重要,因为它表明,考虑共病而不仅仅是年龄的替代临床决策方法,对于 COVID-19 患者住院管理可能尤其重要。