Facci M, Previti A
Department of Internal Medicine, «Alto Vicentino» Hospital, Via Garziere nr 12, 36014, Santorso, Vicenza, Italy.
Department of Nephrology and Dialysis, «Alto Vicentino» Hospital, Via Garziere nr 12, 36014, Santorso, Vicenza, Italy, e-mail:
Adv Gerontol. 2022;35(6):840-847.
Large proportion of deaths from SARS-CoV-2 infections occurred worldwide, especially in elderly patients. The aim of this research is to investigate the potential risk factors for mortality in the elderly patients with COVID-19. 65 years old or older patients with COVID-19 admitted to the Hospital «Alto Vicentino» of Santorso, Vicenza, from 23th February to 25th May 2020, were enrolled in this retrospective cohort study. Data of demographics, clinical features, comorbidities and blood tests were collected and compared for different outcomes. Charlson Comorbidity Index (CCI), Barthel Index (BI) and Modified Early Warning Score (MEWS) were evaluated. Univariate and multivariate logistic regression analyses were performed to explore risk factors for death. 243 patients with mean age 81,3±8,4 years were enrolled, of which 121 (49,8%) were females. This cohort included 11 (4,5%) mild, 131 (53,9%) moderate, 94 (38,7%) severe, 7 (2,9%) critical cases. CCI and BI were 2,8±2,1 points and 31,3±34,9 points respectively. Lethality rate was 28,4% (69 cases). Univariate logistic regression showed a significant increase in mortality risk with increasing age, CCI, polypharmacy, MEWS, Severity Index and reduced BI. Among blood tests thrombocytopenia, high CRP and elevated LDH showed a significant correlation with mortality. In the multivariate logistic regression high CCI, low BI and thrombocytopenia remained to be predictors of death. Tools, which evaluate functional dependence like BI and multiple morbidity like CCI, can be useful in identifying the elderly patients with COVID-19 at greater risk.
新型冠状病毒肺炎（SARS-CoV-2）感染导致全球大量死亡，尤其是老年患者。本研究旨在调查老年新冠肺炎患者死亡的潜在危险因素。2020年2月23日至5月25日期间，入住维琴察省桑托索市“阿尔托·维琴蒂诺”医院的65岁及以上新冠肺炎患者被纳入这项回顾性队列研究。收集了人口统计学、临床特征、合并症和血液检查数据，并针对不同结局进行比较。评估了查尔森合并症指数（CCI）、巴氏指数（BI）和改良早期预警评分（MEWS）。进行单因素和多因素逻辑回归分析以探索死亡危险因素。共纳入243例患者，平均年龄81.3±8.4岁，其中121例（49.8%）为女性。该队列包括11例（4.5%）轻症、131例（53.9%）中症、94例（38.7%）重症、7例（2.9%）危重症病例。CCI和BI分别为2.8±2.1分和31.3±34.9分。致死率为28.4%（69例）。单因素逻辑回归显示，随着年龄、CCI、联合用药、MEWS、严重程度指数增加以及BI降低，死亡风险显著增加。血液检查中，血小板减少、高CRP和LDH升高与死亡率显著相关。在多因素逻辑回归中，高CCI、低BI和血小板减少仍是死亡的预测因素。像BI这样评估功能依赖以及像CCI这样评估多种合并症的工具，有助于识别死亡风险更高的老年新冠肺炎患者。
