Center for Applied Health Research, Baylor Scott & White Research Institute, Dallas, TX, USA.
Department of Medicine, Baylor College of Medicine, Houston, TX, USA.
J Gen Intern Med. 2024 Aug;39(10):1811-1819. doi: 10.1007/s11606-024-08744-4. Epub 2024 Apr 8.
Despite the variability and complexity of geriatric conditions, few COVID-19 reports of clinical characteristic prognostication provide data specific to oldest-old adults (over age 85), and instead generally report broadly as 65 and older.
To examine metabolic syndrome criteria in adults across 25 hospitals with variation in chronological age.
This cohort study examined 39,564 hospitalizations of patients aged 18 or older with COVID-19 who received inpatient care between March 13, 2020, and February 28, 2022.
ICU admission and/or in-hospital mortality.
Metabolic syndrome criteria and patient demographics were examined as risk factors. The main outcomes were admission to ICU and hospital mortality.
Oldest old patients (≥ 85 years) hospitalized with COVID-19 accounted for 7.0% (2758/39,564) of all adult hospitalizations. They had shorter ICU length of stay, similar overall hospitalization duration, and higher rates of discharge destinations providing healthcare services (i.e., home health, skilled nursing facility) compared to independent care. Chronic conditions varied by age group, with lower proportions of diabetes and uncontrolled diabetes in the oldest-old cohort compared with young-old (65-74 years) and middle-old (75-84 years) groups. Evaluations of the effect of metabolic syndrome and patient demographics (i.e., age, sex, race) on ICU admission demonstrate minimal change in the magnitude of effect for metabolic syndrome on ICU admission across the different models.
Metabolic syndrome measures are important individual predictors of COVID-19 outcomes. Building on prior examinations that metabolic syndrome is associated with death and ARDS across all ages, this analysis supports that metabolic syndrome criteria may be more relevant than chronological age as risk factors for poor outcomes attributed to COVID-19.
尽管老年病的情况存在变异性和复杂性，但很少有关于 COVID-19 临床特征预后的报告提供专门针对最老年人群体（85 岁以上）的数据，而是通常笼统地报告为 65 岁及以上。
研究 25 家医院不同年龄的成年人代谢综合征标准。
这项队列研究检查了 2020 年 3 月 13 日至 2022 年 2 月 28 日期间因 COVID-19 接受住院治疗的年龄在 18 岁及以上的 39564 名住院患者。
入住 ICU 和/或院内死亡。
代谢综合征标准和患者人口统计学特征被视为危险因素。主要结果是入住 ICU 和医院死亡率。
患有 COVID-19 的最老年患者（≥85 岁）占所有成年住院患者的 7.0%（2758/39564）。与独立护理相比，他们的 ICU 入住时间更短，整体住院时间相似，出院目的地提供医疗服务（即家庭健康、熟练护理设施）的比例更高。慢性疾病随年龄组而异，最老年组的糖尿病和未控制糖尿病比例低于年轻老年（65-74 岁）和中年老年（75-84 岁）组。评估代谢综合征和患者人口统计学特征（即年龄、性别、种族）对 ICU 入住的影响表明，代谢综合征对 ICU 入住的影响程度在不同模型中变化不大。
代谢综合征测量是 COVID-19 结局的重要个体预测指标。在先前的研究表明代谢综合征与所有年龄段的死亡和 ARDS 相关的基础上，这项分析支持代谢综合征标准可能比年龄更能作为 COVID-19 不良结局的危险因素。
