دورية أكاديمية
أعرض في EDS

Performance of the APOP-screener for predicting in-hospital mortality in older COVID-19 patients: a retrospective study.

التفاصيل البيبلوغرافية
العنوان: Performance of the APOP-screener for predicting in-hospital mortality in older COVID-19 patients: a retrospective study.
المؤلفون: van der Velde MGAM; Department of Internal Medicine, Máxima MC, De Run 4600, Veldhoven-Eindhoven, 5504 DB, The Netherlands. Marleen.van.der.velde@mmc.nl.; Department of Health Services Research, and CAPHRI School for Public Health and Primary Care, Aging and Long Term care Maastricht, Maastricht, the Netherlands. Marleen.van.der.velde@mmc.nl., van der Aa MJ; Department of Geriatric Medicine, Jeroen Bosch Hospital, 's Hertogenbosch, the Netherlands., van Daal MHC; Department of Internal Medicine, Máxima MC, De Run 4600, Veldhoven-Eindhoven, 5504 DB, The Netherlands., Kremers MNT; Department of Internal Medicine, Máxima MC, De Run 4600, Veldhoven-Eindhoven, 5504 DB, The Netherlands.; Department of Health Services Research, and CAPHRI School for Public Health and Primary Care, Aging and Long Term care Maastricht, Maastricht, the Netherlands.; Department of Emergency Medicine, Sint Jans Gasthuis, Weert, The Netherlands., Keijsers CJPW; Department of Geriatric Medicine, Jeroen Bosch Hospital, 's Hertogenbosch, the Netherlands., van Kuijk SMJ; Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Center, Maastricht, The Netherlands., Haak HR; Department of Internal Medicine, Máxima MC, De Run 4600, Veldhoven-Eindhoven, 5504 DB, The Netherlands.; Department of Health Services Research, and CAPHRI School for Public Health and Primary Care, Aging and Long Term care Maastricht, Maastricht, the Netherlands.; Department of Internal Medicine, Division of General Internal Medicine, Maastricht University Medical Center, Maastricht, the Netherlands.
المصدر: BMC geriatrics [BMC Geriatr] 2022 Jul 15; Vol. 22 (1), pp. 584. Date of Electronic Publication: 2022 Jul 15.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: BioMed Central Country of Publication: England NLM ID: 100968548 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2318 (Electronic) Linking ISSN: 14712318 NLM ISO Abbreviation: BMC Geriatr Subsets: MEDLINE
أسماء مطبوعة: Original Publication: London : BioMed Central, [2001]-
مواضيع طبية MeSH: COVID-19* , Frailty*/epidemiology, Aged ; Frail Elderly ; Geriatric Assessment/methods ; Hospital Mortality ; Humans ; Retrospective Studies
مستخلص: Background: A variety of prediction models concerning COVID-19 have been proposed since onset of the pandemic, but to this date no gold standard exists. Mortality rates show a sharp increase with advancing age but with the large heterogeneity of this population in terms of comorbidities, vulnerability and disabilities, identifying risk factors is difficult. Therefore, we aimed to research the multidimensional concept of frailty, measured by the Acute Presenting Older Patient (APOP)-screener, as a risk factor for in-hospital mortality in older COVID-19 patients.
Methods: All consecutive patients of 70 years or older, with a PCR confirmed COVID-19 infection and a completed APOP-score, presenting at the Emergency Department (ED) of the Jeroen Bosch Hospital, the Netherlands, between February 27th 2020 and February 1st 2021 were retrospectively included. We gathered baseline characteristics and scored the CCI and CFS from patient records. The primary outcome was in-hospital mortality.
Results: A total of 292 patients met the inclusion criteria. Approximately half of the patients were considered frail by the APOP or CFS. 127 patients (43.5%) scored frail on the CFS, 158 (54.1%) scored high risk on the APOP-screener. 79 patients (27.1%) died during their hospital admission. The APOP-screener showed a significantly elevated risk of in-hospital mortality when patients scored both high risk of functional and evidence of cognitive impairment (OR 2.24, 95% 1.18-4.25). Significant elevation of in-hospital mortality was found for the high CCI-scores (≥ 5)(OR 1.78, 95% 1.02-3.11), but not for the highest CFS category (5-9, frail) (OR 1.35, 95% 0.75-2.47). The discriminatory performance of the APOP, CFS and CCI were comparable (AUC resp. 0.59 (0.52-0.66), 0.54 (0.46-0.62) and 0.58 (0.51-0.65)).
Conclusion: Although the elevated risk for in-hospital mortality found for the most frail patients as scored by the APOP, this instrument has poor discriminatory value. Additionally, the CFS did not show significance in predicting in-hospital mortality and had a poor discriminatory value as well. Therefore, treatment decisions based on frailty or comorbidities alone should be made with caution. Approaching the heterogeneity of the older population by adding frailty as assessed by the APOP-score to existing prediction models may enhance the predictive value of these models.
(© 2022. The Author(s).)
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فهرسة مساهمة: Keywords: COVID-19; Frailty; Mortality; Predictive; SARS-Cov2
تواريخ الأحداث: Date Created: 20220715 Date Completed: 20220719 Latest Revision: 20230410
رمز التحديث: 20230410
مُعرف محوري في PubMed: PMC9284964
DOI: 10.1186/s12877-022-03274-2
PMID: 35840904
قاعدة البيانات: MEDLINE
الوصف
تدمد:1471-2318
DOI:10.1186/s12877-022-03274-2