Evidence map›Paper›PMID 35840904›Full record

ArticleBMC geriatrics2022

Performance of the APOP-screener for predicting in-hospital mortality in older COVID-19 patients: a retrospective study.

Marleen G A M van der Velde, Merel J van der Aa, Merel H C van Daal, Marjolein N T Kremers, Carolina J P W Keijsers, Sander M J van Kuijk, Harm R Haak

Open access · goldAbstract read
In one paragraph

Article in BMC geriatrics, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.4field-weighted citation impact, top 42% of its field
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

4 citing papers in PubMed, 3 citations in OpenAlex.

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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

7 authors at 5 institutions in 1 country.

Marleen G A M van der Velde *Department of Internal Medicine, Máxima MC, De Run 4600, Veldhoven-Eindhoven, 5504 DB, The Netherlands. Marleen.van.der.velde@mmc.nl.
Merel J van der Aa *Department of Geriatric Medicine, Jeroen Bosch Hospital, 's Hertogenbosch, the Netherlands.
Merel H C van DaalDepartment of Internal Medicine, Máxima MC, De Run 4600, Veldhoven-Eindhoven, 5504 DB, The Netherlands.
Marjolein N T KremersDepartment of Internal Medicine, Máxima MC, De Run 4600, Veldhoven-Eindhoven, 5504 DB, The Netherlands.
Carolina J P W KeijsersDepartment of Geriatric Medicine, Jeroen Bosch Hospital, 's Hertogenbosch, the Netherlands.
Sander M J van KuijkDepartment of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Center, Maastricht, The Netherlands.
Harm R HaakDepartment of Internal Medicine, Máxima MC, De Run 4600, Veldhoven-Eindhoven, 5504 DB, The Netherlands.
Jeroen Bosch Ziekenhuis · NLRadboud University Nijmegen · NLMaastricht University · NLMáxima Medisch Centrum · NLSt.Jans Gasthuis Weert · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundA variety of prediction models concerning COVID-19 have been proposed since onset of the pandemic, but to this date no gold standard exists. Mortality rates show a sharp increase with advancing age but with the large heterogeneity of this population in terms of comorbidities, vulnerability and disabilities, identifying risk factors is difficult. Therefore, we aimed to research the multidimensional concept of frailty, measured by the Acute Presenting Older Patient (APOP)-screener, as a risk factor for in-hospital mortality in older COVID-19 patients.

methodsAll consecutive patients of 70 years or older, with a PCR confirmed COVID-19 infection and a completed APOP-score, presenting at the Emergency Department (ED) of the Jeroen Bosch Hospital, the Netherlands, between February 27th 2020 and February 1st 2021 were retrospectively included. We gathered baseline characteristics and scored the CCI and CFS from patient records. The primary outcome was in-hospital mortality.

resultsA total of 292 patients met the inclusion criteria. Approximately half of the patients were considered frail by the APOP or CFS. 127 patients (43.5%) scored frail on the CFS, 158 (54.1%) scored high risk on the APOP-screener. 79 patients (27.1%) died during their hospital admission. The APOP-screener showed a significantly elevated risk of in-hospital mortality when patients scored both high risk of functional and evidence of cognitive impairment (OR 2.24, 95% 1.18-4.25). Significant elevation of in-hospital mortality was found for the high CCI-scores (≥ 5)(OR 1.78, 95% 1.02-3.11), but not for the highest CFS category (5-9, frail) (OR 1.35, 95% 0.75-2.47). The discriminatory performance of the APOP, CFS and CCI were comparable (AUC resp. 0.59 (0.52-0.66), 0.54 (0.46-0.62) and 0.58 (0.51-0.65)).

conclusionAlthough the elevated risk for in-hospital mortality found for the most frail patients as scored by the APOP, this instrument has poor discriminatory value. Additionally, the CFS did not show significance in predicting in-hospital mortality and had a poor discriminatory value as well. Therefore, treatment decisions based on frailty or comorbidities alone should be made with caution. Approaching the heterogeneity of the older population by adding frailty as assessed by the APOP-score to existing prediction models may enhance the predictive value of these models.

Indexed as

COVID-19FrailtyAgedFrail ElderlyGeriatric AssessmentHospital MortalityHumansRetrospective StudiesCOVID-19FrailtyMortalityPredictiveSARS-Cov2

Identifiers

PMID35840904
PMCPMC9284964
OpenAlexW4285492286

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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.