De Vita Elda, Veronese Nicola, Guido Giacomo, Frallonardo Luisa, Cotugno Sergio, Cesari Giorgia Manco, Cibelli Marinella, Vigna Alessandra, Capruzzi Davide, Fiorella Monica, Santoro Carmen Rita, Brindicci Gaetano, Di Gennaro Francesco, Saracino Annalisa
Clinic of Infectious Diseases, Department of Precision and Regenerative Medicine and Ionian Area - (DiMePRe-J), University of "Aldo Moro", University of Bari "Aldo Moro", Bari, Italy.
Department of Health Promotion, Mother Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy.
Front Public Health. 2025 Jul 2;13:1591767. doi: 10.3389/fpubh.2025.1591767. eCollection 2025.
The COVID-19 pandemic has disproportionately impacted frail individuals, highlighting the urgent need for effective prognostic tools to improve patient outcomes. Early identification of at-risk individuals can optimize management and resource allocation, reducing mortality and morbidity. This study evaluates the Frailty Index-Laboratory (FI-LAB) as a predictor of mortality in COVID-19 patients.
We included all COVID-19 patients admitted to the Clinic of Infectious Diseases of the "Azienda Ospedaliera Policlinico di Bari" from March 2020 to February 2024. FI-LAB scores were calculated using 37 laboratory parameters obtained within the first 4 days of hospitalization. Mortality data were collected up to 90 days post-admission. Cox regression analysis, adjusting for demographics, comorbidities, COVID-19 symptoms, and vaccination status, was employed to examine the relationship between FI-LAB scores and mortality.
One thousand, four hundred ninety-two patients were included in the study population, the mean age was 57.2 years (SD = 15.9), with 56.6% being male. Patients in the highest FI-LAB tertile (>0.432) exhibited a 17.10-fold higher risk of death compared to those in the lowest tertile (<0.135), same result has been shown in the intermediate FI-LAB scores (0.135-0.432) when compared to the lowest tertile. Additionally, each 0.10-point increase in FI-LAB was linked to a nearly twofold increase in mortality hazard (HR = 1.99, 95% CI 1.69-2.37, < 0.0001).
Frailty Index-Laboratory is a robust and practical tool for predicting mortality in hospitalized COVID-19 patients, aiding early identification of high-risk individuals. Implementing FI-LAB enhances patient management and resource allocation. Further studies are needed to confirm its effectiveness across diverse populations and healthcare settings.
新冠疫情对体弱个体产生了尤为严重的影响，凸显了迫切需要有效的预后工具来改善患者预后。早期识别高危个体可优化管理和资源分配，降低死亡率和发病率。本研究评估了衰弱指数-实验室（FI-LAB）作为新冠患者死亡率预测指标的作用。
我们纳入了2020年3月至2024年2月期间入住“巴里综合医院传染病诊所”的所有新冠患者。FI-LAB评分使用入院后前4天内获得的37项实验室参数计算得出。收集入院后90天内的死亡率数据。采用Cox回归分析，对人口统计学、合并症、新冠症状和疫苗接种状况进行调整，以研究FI-LAB评分与死亡率之间的关系。
1492名患者纳入研究人群，平均年龄为57.2岁（标准差=15.9），男性占56.6%。FI-LAB三分位数最高组（>0.432）的患者死亡风险比最低组（<0.135）高17.10倍，与最低组相比，FI-LAB中间评分组（0.135 - 0.432）也显示出相同结果。此外，FI-LAB每增加0.10分，死亡风险增加近两倍（风险比=1.99，95%置信区间1.69 - 2.37，P<0.0001）。
衰弱指数-实验室是预测住院新冠患者死亡率的有力且实用的工具，有助于早期识别高危个体。应用FI-LAB可加强患者管理和资源分配。需要进一步研究以确认其在不同人群和医疗环境中的有效性。
