Centre for Research and Development, Uppsala University/Region Gävleborg, Gävle, Sweden.
Department of Neuroscience, Speech and Language Pathology, Uppsala University, Uppsala, Sweden.
Infect Dis (Lond). 2022 Aug;54(8):583-590. doi: 10.1080/23744235.2022.2060304. Epub 2022 Apr 8.
The coronavirus disease 2019 pandemic makes proper resource allocation and prioritisation important. Frailty increases the risk of adverse outcomes and can be quantified using the Clinical frailty scale. The aim of this study was to determine the role of the Clinical frailty scale, in patients ≥65 years of age with coronavirus disease 2019, as a risk factor either for critical coronavirus disease 2019 measured as intensive care unit admission or death or as a risk factor for death.
This was a retrospective observational study on patients ≥65 years hospitalised with coronavirus disease 2019 verified by polymerase chain reaction between 5 March 5 and 5 July 2020. The association between Clinical frailty scale and the composite primary outcome intensive care unit admission or death within 30 days post hospitalisation and the secondary outcome death within 30 days post hospitalisation was analysed using multivariable logistic regression models adjusting for gender, age, body mass index, hypertension, and diabetes. Clinical frailty scale was used as a categorical variable (fit score 1-4, frail score 5-6, and severely frail score 7-9).
In total, 169 patients were included (47.3% women, mean age 79.2 ± 7.8 years). In the fully adjusted model, adjusted odds ratio for intensive care unit admission or death was 1.84 (95%-confidence interval 0.67-5.03, = .234) for frail and 6.08 (1.70-21.81, = .006) for severely frail compared to fit patients. For death, adjusted odds ratio was 2.81 (0.89-8.88, = .079) for frail and 9.82 (2.53-38.10, = .001) for severely frail compared to fit patients.
A high Clinical frailty scale score was an independent risk factor for the composite outcome intensive care unit admission or death and for the secondary outcome death.
2019 年冠状病毒病大流行使得资源的合理分配和优先化变得尤为重要。衰弱会增加不良结果的风险，并且可以使用临床虚弱量表进行量化。本研究的目的是确定临床虚弱量表在年龄≥65 岁的 2019 年冠状病毒病患者中的作用，作为一个危险因素，无论是对于重症 2019 年冠状病毒病（以重症监护病房入院或死亡来衡量），还是对于死亡的危险因素。
这是一项回顾性观察性研究，纳入了 2020 年 3 月 5 日至 7 月 5 日期间通过聚合酶链反应确诊的年龄≥65 岁的因 2019 年冠状病毒病住院的患者。使用多变量逻辑回归模型分析临床虚弱量表与住院后 30 天内重症监护病房入院或死亡的复合主要结局以及住院后 30 天内死亡的次要结局之间的关联，并对性别、年龄、体重指数、高血压和糖尿病进行了调整。临床虚弱量表作为一个分类变量（功能评分 1-4、虚弱评分 5-6、严重虚弱评分 7-9）。
共纳入 169 例患者（47.3%为女性，平均年龄 79.2±7.8 岁）。在完全调整模型中，与功能良好的患者相比，虚弱患者的重症监护病房入院或死亡的调整后优势比为 1.84（95%置信区间 0.67-5.03， = .234），严重虚弱患者为 6.08（1.70-21.81， = .006）。对于死亡，与功能良好的患者相比，虚弱患者的调整后优势比为 2.81（0.89-8.88， = .079），严重虚弱患者为 9.82（2.53-38.10， = .001）。
较高的临床虚弱量表评分是重症监护病房入院或死亡的复合结局以及次要结局死亡的独立危险因素。
