Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/30172
Title: Frailty and mortality associations in patients with COVID-19: a systematic review and meta-analysis.
Austin Authors: Subramaniam, Ashwin;Shekar, Kiran;Afroz, Afsana;Ashwin, Sushma;Billah, Baki;Brown, Hamish;Kundi, Harun;Lim, Zheng Jie;Ponnapa Reddy, Mallikarjuna;Curtis, J Randall
Affiliation: Anaesthesia..
Queensland University of Technology, Brisbane, Queensland, Australia..
Bond University, Gold Coast, Queensland, Australia..
Centre for Integrated Critical Care, Department of Medicine and Radiology, Melbourne Medical School, Melbourne, Victoria, Australia..
Department of Health Economics, School of Health and Social Development, Deakin University, Melbourne, Victoria, Australia..
Department of Intensive Care Medicine, Calvary Hospital, Canberra, Australian Capital Territory, Australia..
Department of Intensive Care Medicine, Peninsula Health, Melbourne, Victoria, Australia..
Peninsula Clinical School, Monash University, Melbourne, Victoria, Australia..
Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia..
Adult Intensive Care Services, The Prince Charles Hospital, Brisbane, Queensland, Australia..
University of Queensland, Brisbane, Queensland, Australia..
Department of Cardiology, Ankara City Hospital, Ankara, Turkey..
Cambia Palliative Care Centre of Excellence, University of Washington, Seattle, Washington, USA.. Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of Washington, Seattle, Washington, USA..
Issue Date: May-2022
Date: 2022-03-21
Publication information: Internal medicine journal 2022; 52(5): 724-739
Abstract: Observational data during the pandemic have demonstrated mixed associations between frailty and mortality. To examine associations between frailty and short-term mortality in patients hospitalised with coronavirus disease 2019 (COVID-19). In this systematic review and meta-analysis, we searched PubMed, Embase and the COVID-19 living systematic review from 1 December 2019 to 15 July 2021. Studies reporting mortality and frailty scores in hospitalised patients with COVID-19 (age ≥18 years) were included. Data on patient demographics, short-term mortality (in hospital or within 30 days), intensive care unit (ICU) admission and need for invasive mechanical ventilation (IMV) were extracted. The quality of studies was assessed using the Newcastle-Ottawa Scale. Twenty-five studies reporting 34 628 patients were included. Overall, 26.2% (n = 9061) died. Patients who died were older (76.7 ± 9.6 vs 69.2 ± 13.4), more likely male (risk ratio (RR) = 1.08; 95% confidence interval (CI): 1.06-1.11) and had more comorbidities. Fifty-eight percent of patients were frail. Adjusting for age, there was no difference in short-term mortality between frail and non-frail patients (RR = 1.04; 95% CI: 0.84-1.28). The non-frail patients were commonly admitted to ICU (27.2% (4256/15639) vs 29.1% (3567/12274); P = 0.011) and had a higher mortality risk (RR = 1.63; 95% CI: 1.30-2.03) than frail patients. Among patients receiving IMV, there was no difference in mortality between frail and non-frail (RR = 1.62; 95% CI 0.93-2.77). This systematic review did not demonstrate an independent association between frailty status and short-term mortality in patients with COVID-19. Patients with frailty were less commonly admitted to ICU and non-frail patients were more likely to receive IMV and had higher mortality risk. This finding may be related to allocation decisions for patients with frailty amidst the pandemic.
URI: https://ahro.austin.org.au/austinjspui/handle/1/30172
DOI: 10.1111/imj.15698
ORCID: 0000-0002-8292-7357
0000-0002-3470-6701
0000-0001-8864-4844
Journal: Internal medicine journal
PubMed URL: 35066970
PubMed URL: https://pubmed.ncbi.nlm.nih.gov/35066970/
Type: Journal Article
Subjects: COVID-19
frailty
hospital-related mortality
meta-analysis
older people
systematic review
Appears in Collections:Journal articles

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