Abstract
Background
COVID-19 has disproportionately affected older people.
Objective
to investigate whether frailty is associated with all-cause mortality in older hospital inpatients, with COVID-19.
Design
cohort study.
Setting
secondary care acute hospital.
Participants
six hundred and seventy-seven consecutive inpatients aged 65 years and over.
Methods
Cox proportional hazards models were used to examine the association of frailty with mortality. Frailty was assessed at baseline, according to the Clinical Frailty Scale (CFS), where higher categories indicate worse frailty. Analyses were adjusted for age, sex, deprivation, ethnicity, previous admissions and acute illness severity.
Results
six hundred and sixty-four patients were classified according to CFS. Two hundred and seventy-one died, during a mean follow-up of 34.3 days. Worse frailty at baseline was associated with increased mortality risk, even after full adjustment (p = 0.004). Patients with CFS 4 and CFS 5 had non-significant increased mortality risks, compared to those with CFS 1–3. Patients with CFS 6 had a 2.13-fold (95% CI 1.34–3.38) and those with CFS 7–9 had a 1.79-fold (95% CI 1.12–2.88) increased mortality risk, compared to those with CFS 1–3 (p = 0.001 and 0.016, respectively). Older age, male sex and acute illness severity were also associated with increased mortality risk.
Conclusions
frailty is associated with all-cause mortality risk in older inpatients with COVID-19.
Keywords: longitudinal study, mortality, COVID-19, frailty, older adults