Observational studyJournal of the American Medical Directors Association2021
Frailty Assessment in the Emergency Department for Risk Stratification of COVID-19 Patients Aged ≥80 Years.
Observational study in Journal of the American Medical Directors Association, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 1 of them a synthesis that pooled it.
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Who cites it
27 citing papers in PubMed, 1 synthesis or guideline pooled it, 53 citations in OpenAlex.
- The devastating trio of sarcopenia, frailty, and COVID-19 - A systematic review and meta-analysis.Clinical nutrition ESPEN · 2022Pooled it
- Physical activity during COVID-19 pandemic: A 5-year retrospect.Sports medicine and health science · 2025Review
- Skeletal Muscle Quality Evaluation for Prognostic Stratification in the Emergency Department of Patients ≥65 Years with Major Trauma.Journal of clinical medicine · 2025Article
- Frailty is a prognostic marker of mortality and sepsis in patients ≥ 70 years with acute left-sided colonic diverticulitis.International journal of colorectal disease · 2025Article
- Multimorbidity and COVID-19 Outcomes in the Emergency Department: Is the Association Mediated by the Severity of the Condition at Admission?Journal of clinical medicine · 2024Article
- Retrospective Study on the Features and Outcomes of a Tuscany COVID-19 Hospitalized Patients Cohort: Preliminary Results.Journal of clinical medicine · 2024Article
- The Multidisciplinary Mobile Unit (MMU) Program Bringing Hospital Specialist Geriatric Competencies at Home: A Feasible Alternative to Admission in Older Patients with Urgent Complaints.Journal of clinical medicine · 2024Article
- Frailty assessment tools in the emergency department: A geriatric emergency department guidelines 2.0 scoping review.Journal of the American College of Emergency Physicians open · 2024Article
- The Association Between Frailty Evaluated by Clinical Frailty Scale and Mortality of Older Patients in the Emergency Department: A Prospective Cohort Study.Clinical interventions in aging · 2024Observational
- The Clinical Frailty Scale (CFS) as an Independent Prognostic Factor for Patients ≥80 Years with Small Bowel Obstruction (SBO).Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2023Article
- Reduced Prognostic Role of Serum PCT Measurement in Very Frail Older Adults Admitted to the Emergency Department.Antibiotics (Basel, Switzerland) · 2023Article
- Long COVID and hypertension-related disorders: a report from the Japanese Society of Hypertension Project Team on COVID-19.Hypertension research : official journal of the Japanese Society of Hypertension · 2023Review
- Risk factors and outcomes of delirium in hospitalized older adults with COVID-19: A systematic review and meta-analysis.Aging and health research · 2023Review
- Association between Clinical Frailty Scale (CFS) and clinical presentation and outcomes in older inpatients with COVID-19.BMC geriatrics · 2023Article
- Approach to COVID-19 in older adults and indications for improving the outcomes.Annals of medicine · 2023Review
- Long-Term Effects of Hospitalization for COVID-19 on Frailty and Quality of Life in Older Adults ≥80 Years.Journal of clinical medicine · 2022Article
- Promote COVID-19 Vaccination for Older Adults in China.China CDC weekly · 2022Article
- Reply to "In-Hospital Mortality Risk of Older Patients With COVID-19 Infection".Journal of the American Medical Directors Association · 2022Article
- In-Hospital Mortality Risk of Older Patients With COVID-19 Infection.Journal of the American Medical Directors Association · 2022Article
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Authors and funding
10 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo evaluate, in a cohort of adults aged ≥80 years, the overlapping effect of clinical severity, comorbidities, cognitive impairment, and frailty, for the in-hospital death risk stratification of COVID-19 older patients since emergency department (ED) admission.
designSingle-center prospective observational cohort study. SETTING AND
participantsThe study was conducted in the ED of a teaching hospital that is a referral center for COVID-19 in central Italy. We enrolled all patients with aged ≥80 years old consecutively admitted to the ED between April 2020 and March 2021.
methodsClinical variables assessed in the ED were evaluated for the association with all-cause in-hospital death. Evaluated parameters were severity of disease, frailty, comorbidities, cognitive impairment, delirium, and dependency in daily life activities. Cox regression analysis was used to identify independent risk factors for poor outcomes.
resultsA total of 729 patients aged ≥80 years were enrolled [median age 85 years (interquartile range 82-89); 346 were males (47.3%)]. According to the Clinical Frailty Scale, 61 (8.4%) were classified as fit, 417 (57.2%) as vulnerable, and 251 (34.4%) as frail. Severe disease [hazard ratio (HR) 1.87, 95% confidence interval (CI) 1.31-2.59], ≥3 comorbidities (HR 1.54, 95% CI 1.11-2.13), male sex (HR 1.46, 95% CI 1.14-1.87), and frailty (HR 6.93, 95% CI 1.69-28.27) for vulnerable and an overall HR of 12.55 (95% CI 2.96-53.21) for frail were independent risk factors for in-hospital death. CONCLUSIONS AND IMPLICATIONS: The ED approach to older patients with COVID-19 should take into account the functional and clinical characteristics of patients being admitted. A sole evaluation based on the clinical severity and the presence of comorbidities does not reflect the complexity of this population. A comprehensive evaluation based on clinical severity, multimorbidity, and frailty could effectively predict the clinical risk of in-hospital death for patients with COVID-19 aged ≥80 years at the time of ED presentation.
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