Evidence map›Paper›PMID 33334341›Full record

Observational studyBMC medicine2020

Increased care at discharge from COVID-19: The association between pre-admission frailty and increased care needs after hospital discharge; a multicentre European observational cohort study.

A Vilches-Moraga, A Price, P Braude, L Pearce, R Short, A Verduri, M Stechman, J T Collins, E Mitchell, A G Einarsson and 8 more

Abstract readMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in BMC medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
16citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

16 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Guideline
  2. Pooled it
  3. Article
  4. Article
  5. Article
  6. COVID-19 Sequelae and Their Implications on Social Services.Journal of Korean medical science · 2022
    Article
  7. Observational
  8. Article
  9. Article
  10. Review
  11. Review
  12. Article
  13. [COVID-19 in old age-The geriatric perspective].Zeitschrift fur Gerontologie und Geriatrie · 2021
    Review
  14. Article
  15. Article
  16. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors.

A Vilches-MoragaFaculty of Medical and Human Services, University of Manchester, Manchester, England.
A PriceSalford Royal Hospital Foundation Trust, Salford, England.
P BraudeNorth Bristol NHS Trust, Bristol, England.
L PearceFaculty of Medical and Human Services, University of Manchester, Manchester, England.
R ShortDepartment of Biostatistics and Health Informatics, King's College London, London, England.
A VerduriUniversity Hospital of Modena Policlinico, University of Modena and Reggio Emilia, Modena, Italy.
M StechmanUniversity Hospital of Wales, Cardiff University, Cardiff, Wales.
J T CollinsYsbyty Ystrad Fawr, Aneurin Bevan University Health Board, Newport, Wales.
E MitchellNorth Bristol NHS Trust, Bristol, England.
A G EinarssonNHS Grampian, Aberdeen, UK.
S J MougRoyal Alexandra Hospital, Paisley, Scotland.
T J QuinnGlasgow Royal Infirmary, Glasgow, Scotland.
B StubbsPhysiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London, UK.
K McCarthyNorth Bristol NHS Trust, Bristol, England.
P K MyintUniversity of Aberdeen, Aberdeen, Scotland.
J HewittAneurin Bevan Health Board, Cardiff University, Cardiff, Wales.
B CarterDepartment of Biostatistics and Health Informatics, King's College London, London, England. ben.carter@kcl.ac.uk.
COPE Study

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe COVID-19 pandemic has placed significant pressure on health and social care. Survivors of COVID-19 may be left with substantial functional deficits requiring ongoing care. We aimed to determine whether pre-admission frailty was associated with increased care needs at discharge for patients admitted to hospital with COVID-19.

methodsPatients were included if aged over 18 years old and admitted to hospital with COVID-19 between 27 February and 10 June 2020. The Clinical Frailty Scale (CFS) was used to assess pre-admission frailty status. Admission and discharge care levels were recorded. Data were analysed using a mixed-effects logistic regression adjusted for age, sex, smoking status, comorbidities, and admission CRP as a marker of severity of disease.

resultsThirteen hospitals included patients: 1671 patients were screened, and 840 were excluded including, 521 patients who died before discharge (31.1%). Of the 831 patients who were discharged, the median age was 71 years (IQR, 58-81 years) and 369 (44.4%) were women. The median length of hospital stay was 12 days (IQR 6-24). Using the CFS, 438 (47.0%) were living with frailty (≥ CFS 5), and 193 (23.2%) required an increase in the level of care provided. Multivariable analysis showed that frailty was associated with an increase in care needs compared to patients without frailty (CFS 1-3). The adjusted odds ratios (aOR) were as follows: CFS 4, 1.99 (0.97-4.11); CFS 5, 3.77 (1.94-7.32); CFS 6, 4.04 (2.09-7.82); CFS 7, 2.16 (1.12-4.20); and CFS 8, 3.19 (1.06-9.56).

conclusionsAround a quarter of patients admitted with COVID-19 had increased care needs at discharge. Pre-admission frailty was strongly associated with the need for an increased level of care at discharge. Our results have implications for service planning and public health policy as well as a person's functional outcome, suggesting that frailty screening should be utilised for predictive modelling and early individualised discharge planning.

Indexed as

COVID-19Quality of LifeAdultAftercareAgedAged, 80 and overCohort StudiesComorbidityFemaleFrailtyHumansMaleMiddle AgedPatient DischargeSARS-CoV-2Care needClinical frailty scaleCOVID-19Discharge destinationFrailtyIncreased care needOlder people

Identifiers

PMID33334341
PMCPMC7746415

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.