Prognostic Value of a Laboratory Index of Frailty in Older Patients Hospitalized for COVID-19: The COMEPA Study.

IF 3.3 Q2 GERIATRICS & GERONTOLOGY
N Veronese, V Briganò, S Ciriminna, A Ganci, F Bifara, F Pollicino, M C Garlisi, F Tantillo, S Amodeo, G Rizzo, L Vernuccio, P Mansueto, A Licata, L Giannitrapani, L J Dominguez, M Barbagallo
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引用次数: 0

Abstract

Background: Several indexes based on clinical and laboratory tests to identify frailty and to predict mortality have been produced. Only two studies, mixing clinical and laboratory parameters were made about a frailty index made of laboratory tests (FI-Lab) and mortality in older patients hospitalized for COVID-19. The aim of this study was to explore the accuracy and precision of an FI-Lab constructed with some common bio-humoral tests and mortality in a cohort of patients hospitalized for COVID-19.

Methods: The FI-Lab was constructed using 40 different bio-humoral tests during the first four days of hospitalization, with a score from 0 to 1. The association between FI-Lab and mortality was assessed using a multivariate Cox's regression analysis, reported as hazard ratios (HRs) and 95% confidence intervals (CIs). The accuracy of the FI-Lab was reported as area under the curve (AUC) and the precision with the C-Index.

Results: 376 patients (mean age: 65 years; 53.7% males) were initially included. During the follow-up period, 41 deceased. After adjusting for five different factors, an FI-Lab value >0.54, the median value of our cohort, was associated with a relative risk about five times greater than lower values. Modeling FI-LAB as a continous variable, each increase in 0.01 points was associated with an increased risk in mortality of 8.4% (HR=1.084; 95%CI: 1.039-2.044). The FI-Lab was highly accurate (AUC=0.91; 95%CI: 0.87-0.95) and precise (C-Index=0.81) in predicting death.

Conclusions: A simple index based on common laboratory tests can be used to predict mortality among older people hospitalized for COVID-19.

因 COVID-19 而住院的老年患者的衰弱实验室指数的预后价值:COMEPA 研究。
背景:目前已有几种基于临床和实验室检查的虚弱指数,可用于识别虚弱程度和预测死亡率。仅有两项研究结合了临床和实验室参数,探讨了由实验室检查(FI-Lab)组成的虚弱指数和因 COVID-19 住院的老年患者的死亡率。本研究的目的是探讨用一些常见的生物-体液测试构建的 FI-Lab 的准确性和精确性,以及 COVID-19 住院患者队列中的死亡率:采用多变量考克斯回归分析评估了FI-Lab与死亡率之间的关系,并以危险比(HRs)和95%置信区间(CIs)进行报告。FI-Lab 的准确度以曲线下面积(AUC)报告,精确度以 C-Index 报告:最初共纳入 376 名患者(平均年龄 65 岁;53.7% 为男性)。在随访期间,有 41 人死亡。在对五种不同因素进行调整后,FI-LAB 值大于 0.54(我们队列中的中位值)的相对风险是较低值的五倍。将 FI-LAB 作为连续变量建模,每增加 0.01 个点,死亡风险就增加 8.4%(HR=1.084;95%CI:1.039-2.044)。FI-Lab在预测死亡方面准确度高(AUC=0.91;95%CI:0.87-0.95),精确度高(C-Index=0.81):结论:基于常见实验室检测的简单指数可用于预测因 COVID-19 住院的老年人的死亡率。
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来源期刊
Journal of Frailty & Aging
Journal of Frailty & Aging GERIATRICS & GERONTOLOGY-
CiteScore
5.90
自引率
7.70%
发文量
54
期刊介绍: The Journal of Frailty & Aging is a peer-reviewed international journal aimed at presenting articles that are related to research in the area of aging and age-related (sub)clinical conditions. In particular, the journal publishes high-quality papers describing and discussing social, biological, and clinical features underlying the onset and development of frailty in older persons.          The Journal of Frailty & Aging is composed by five different sections: - Biology of frailty and aging In this section, the journal presents reports from preclinical studies and experiences focused at identifying, describing, and understanding the subclinical pathophysiological mechanisms at the basis of frailty and aging. - Physical frailty and age-related body composition modifications Studies exploring the physical and functional components of frailty are contained in this section. Moreover, since body composition plays a major role in determining physical frailty and, at the same time, represents the most evident feature of the aging process, special attention is given to studies focused on sarcopenia and obesity at older age. - Neurosciences of frailty and aging The section presents results from studies exploring the cognitive and neurological aspects of frailty and age-related conditions. In particular, papers on neurodegenerative conditions of advanced age are welcomed. - Frailty and aging in clinical practice and public health This journal’s section is devoted at presenting studies on clinical issues of frailty and age-related conditions. This multidisciplinary section particularly welcomes reports from clinicians coming from different backgrounds and specialties dealing with the heterogeneous clinical manifestations of advanced age. Moreover, this part of the journal also contains reports on frailty- and age-related social and public health issues. - Clinical trials and therapeutics This final section contains all the manuscripts presenting data on (pharmacological and non-pharmacological) interventions aimed at preventing, delaying, or treating frailty and age-related conditions.The Journal of Frailty & Aging is a quarterly publication of original papers, review articles, case reports, controversies, letters to the Editor, and book reviews. Manuscripts will be evaluated by the editorial staff and, if suitable, by expert reviewers assigned by the editors. The journal particularly welcomes papers by researchers from different backgrounds and specialities who may want to share their views and experiences on the common themes of frailty and aging.The abstracting and indexing of the Journal of Frailty & Aging is covered by MEDLINE (approval by the National Library of Medicine in February 2016).
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