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老年 COVID-19 住院患者 18 个月后的死亡率和功能结局:一项多中心队列研究。

Mortality and functional outcomes 18 months after hospitalization for COVID-19 in geriatric patients: a multicentric cohort study.

机构信息

Service de gériatrie aigue / UPREG, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Saint Antoine, Paris, France.

Département de gériatrie, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Pitié Salpêtrière, Paris, F75013, France.

出版信息

BMC Geriatr. 2024 Sep 17;24(1):763. doi: 10.1186/s12877-024-05240-6.

Abstract

BACKGROUND

Few data are available on the long-term mortality and functional status of geriatric patients surviving after hospitalization for COVID-19. We compared the mortality and functional status 18 months after hospitalization for geriatric patients who were hospitalized for COVID-19 or another diagnosis.

METHODS

This was a multicentric cohort study in Paris from January to June 2021. We included patients aged 75 years and over who were hospitalized with COVID-19 or not during this period and compared their vital and functional status 18 months after hospitalization.

RESULTS

We included 254 patients (63 hospitalized for COVID-19). As compared with patients hospitalized for other reasons, those hospitalized for COVID-19 were younger (mean [SD] age 86 [6.47] vs. 88 [6.41] years, p = 0.03), less frail (median Clinical Frailty Scale score 5 [4-6] vs. 6 [4-6], p 0.007) and more independent at baseline (median activities of daily living score 5.5 [4-6] vs. 5 [3.5-6], p 0.03; instrumental activities of daily living score 3 [1-4] vs. 2 [0-3], p 0.04). At 18 months, 50.8% (n = 32/63) of COVID-19 patients had died versus 66% (n = 126/191) of non-COVID-19 patients (p 0.03). On multivariate analysis, COVID-19 positivity was not significantly associated with 18-month mortality (adjusted hazard ratio 0.67, 95% confidence interval 0.40 to 1.13). At 18 months, the two groups did not differ in activities of daily living or frailty scores.

CONCLUSIONS

In this multicenter study of long-term mortality in geriatric patients discharged alive after hospitalization, positive COVID-19 status was not associated with excess mortality.

摘要

背景

关于因 COVID-19 住院后幸存的老年患者的长期死亡率和功能状态,目前数据有限。我们比较了因 COVID-19 或其他诊断住院的老年患者在住院后 18 个月的死亡率和功能状态。

方法

这是 2021 年 1 月至 6 月期间在巴黎进行的一项多中心队列研究。我们纳入了在此期间因 COVID-19 或其他原因住院的 75 岁及以上患者,并比较了他们在出院后 18 个月时的生命和功能状态。

结果

我们纳入了 254 名患者(63 名因 COVID-19 住院)。与因其他原因住院的患者相比,因 COVID-19 住院的患者年龄更小(平均[标准差]年龄 86[6.47]岁比 88[6.41]岁,p=0.03)、身体更健康(中位数临床虚弱量表评分为 5[4-6]分比 6[4-6]分,p<0.007)且在基线时独立性更高(平均日常生活活动评分 5.5[4-6]分比 5[3.5-6]分,p=0.03;工具性日常生活活动评分 3[1-4]分比 2[0-3]分,p=0.04)。18 个月时,63 名 COVID-19 患者中有 50.8%(n=32)死亡,191 名非 COVID-19 患者中有 66%(n=126)死亡(p=0.03)。多变量分析显示,COVID-19 阳性与 18 个月死亡率无显著相关性(调整后的危险比 0.67,95%置信区间 0.40 至 1.13)。18 个月时,两组患者的日常生活活动或虚弱评分无差异。

结论

在这项多中心研究中,我们研究了老年患者出院后长期死亡率,结果显示 COVID-19 阳性状态与超额死亡率无关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4f3c/11406854/4590aa23f124/12877_2024_5240_Fig1_HTML.jpg

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