학술논문
Association between Clinical Frailty Scale score and hospital mortality in adult patients with COVID-19 (COMET): an international, multicentre, retrospective, observational cohort study
Document Type
article
Author
Roos S G Sablerolles, MD; Melvin Lafeber, MD; Janneke A L van Kempen, MD; Bob P A van de Loo, Msc; Eric Boersma, ProfPhD; Wim J R Rietdijk, PhD; Harmke A Polinder-Bos, MD; Simon P Mooijaart, MD; Hugo van der Kuy, ProfPharmD; Jorie Versmissen, MD; Miriam C Faes, MD; LA Agnoletto; J Aleman; S Andreassi; LM Andrews; L Ashfield; H Bell; AKB Bengaard; SB Berlinghini; KB Bini; ZB Bisoffi; KB Blum; E Boemaars; GB Boni; TM Bosch; BE Bosma; F Boutkourt; C Bufarini; A Bulsink; RC Cabuk; GC Callens; MC Candela; MC Canonici; EC Capone; IC Carmo; FC Caruso; PC Chessa; GC Cohet; I Cornelissen-Wesseling; KML Crommentuijn; FM de Stoppelaar; HAJM de Wit; DS Deben; LJJ Derijks; MDC Di Carlo; J Diepstraten; B Dilek; DMK Duchek-Mann; MM Ebbens; LJ Ellerbroek; M Ezinga; MF Falcao; FF Falcao; LF Fantini; HF Farinha; PMG Filius; NJ Fitzhugh; G Fleming; TF Forsthuber; GG Gambarelli; MG Gambera; CGY García Yubero; Z Getrouw; CN Ghazarian; N Goodfellow; MQG Gorgas; RG Grinta; K Guda; DH Haider; J Hanley; KH Heitzeneder; WL Hemminga; LC Hendriksen; DL Hilarius; FEF Hogenhuis; IC Hoogendoorn-de Graaf; MBH Houlind; MAH Huebler; KPGM Hurkens; PKC Janssen; E Jong; MHW Kappers; KFM Keijzers; MK Kemogni; EM Kemper; RA Kranenburg; LL Krens; JL G Le Grand; J Liang; S Lim; NL Lindner; EL Loche; AL Lubich; B Maat; CM Maesano; AM Maiworm; M Maragna; FM Marchesini; IM Martignoni; G M Martini; CM Masini; R Mc Menamin; DM Mendes; M Miarons; R Moorlag; MR Müller; FN Nagele; KN Nemec; GO Oka; AG Otten-Helmers; SP Pagliarino; FP Pappalardo; M Patel; PM Peverini; FP Pieraccini; EMP Platania; NPK Pons-Kerjean; LPH Portillo Horcajada; GR Rametta; JR Rijo; EE Roelofsen; E Roobol-Meuwese; LR Rossi; SAH Russel; Z Safipour; FS Salaffi; L Saleh; AMS Schimizzi; JMGA Schols; MS Schwap; MG Scott; EAM Slijfer; EMA Slob; JS Soares; MS Solano; F Sombogaard; GS Stemer; MT Tardella; PGJ ter Horst; RT Tessari; J Tournoy; RB van den Berg; L Van der Linden; PD van der Linden; SC van Dijk; RW Van Etten; IMM van Haelst; M van Heuckelum; HJM van Kan; C van Nieuwkoop; HAW van Onzenoort; P van Wijngaarden; JDJ Verdonk; Fv Verri; JAMC Verstijnen; MV Veyrier; EV Viegas; LE Visser; A Vos; MAM Vromen; PC Wierenga; DR Wong; CZ Zenico; TZ Zuppini
Source
The Lancet. Healthy Longevity, Vol 2, Iss 3, Pp e163-e170 (2021)
Subject
Language
English
ISSN
2666-7568
Abstract
Summary: Background: During the COVID-19 pandemic, the scarcity of resources has necessitated triage of critical care for patients with the disease. In patients aged 65 years and older, triage decisions are regularly based on degree of frailty measured by the Clinical Frailty Scale (CFS). However, the CFS could also be useful in patients younger than 65 years. We aimed to examine the association between CFS score and hospital mortality and between CFS score and admission to intensive care in adult patients of all ages with COVID-19 across Europe. Methods: This analysis was part of the COVID Medication (COMET) study, an international, multicentre, retrospective observational cohort study in 63 hospitals in 11 countries in Europe. Eligible patients were aged 18 years and older, had been admitted to hospital, and either tested positive by PCR for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or were judged to have a high clinical likelihood of having SARS-CoV-2 infection by the local COVID-19 expert team. CFS was used to assess level of frailty: fit (CFS1–3), mildly frail (CFS4–5), or frail (CFS6–9). The primary outcome was hospital mortality. The secondary outcome was admission to intensive care. Data were analysed using a multivariable binary logistic regression model adjusted for covariates (age, sex, number of drugs prescribed, and type of drug class as a proxy for comorbidities). Findings: Between March 30 and July 15, 2020, 2434 patients (median age 68 years [IQR 55–77]; 1480 [61%] men, 954 [30%] women) had CFS scores available and were included in the analyses. In the total sample and in patients aged 65 years and older, frail patients and mildly frail patients had a significantly higher risk of hospital mortality than fit patients (total sample: CFS6–9 vs CFS1–3 odds ratio [OR] 2·71 [95% CI 2·04–3·60], p