Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2021 Dec;12(6):1169-1180.
doi: 10.1007/s41999-021-00541-0. Epub 2021 Jul 21.

Mortality risk factors in a Spanish cohort of oldest-old patients hospitalized with COVID-19 in an acute geriatric unit: the OCTA-COVID study

Isabel Lozano-Montoya  1   2 , Maribel Quezada-Feijoo  3   4 , Javier Jaramillo-Hidalgo  5   3 , Blanca Garmendia-Prieto  5   3 , Pamela Lisette-Carrillo  5   3 , Francisco J Gómez-Pavón  5   3
Affiliations
Observational Study

Mortality risk factors in a Spanish cohort of oldest-old patients hospitalized with COVID-19 in an acute geriatric unit: the OCTA-COVID study

Isabel Lozano-Montoya et al. Eur Geriatr Med. 2021 Dec.

Abstract

Purpose: To determine predictors of in-hospital mortality related to COVID-19 in oldest-old patients.

Design: Single-center observational study.

Setting and participants: Patients ≥ 75 years admitted to an Acute Geriatric Unit with COVID-19.

Methods: Data from hospital admission were retrieved from the electronic medical records: demographics, geriatric syndromes (delirium, falls, polypharmacy, functional and cognitive status) co-morbidities, previous treatments, clinical, laboratory, and radiographic characteristics. Cox proportional hazard models were used to evaluate in-hospital mortality.

Results: Three hundred patients were consecutively included (62.7% females, mean age of 86.3 ± 6.6 years). Barthel Index (BI) was < 60 in 127 patients (42.8%) and 126 (42.0%) had Charlson Index CI ≥ 3. Most patients (216; 72.7%) were frail (Clinical Frailty Scale ≥ 5) and 134 patients (45.1%) had dementia of some degree. The overall in-hospital mortality rate was 37%. The following factors were associated with higher in-hospital mortality in a multi-variant analysis: CURB-65 score = 3-5 (HR 7.99, 95% CI 3.55-19.96, p < 0.001), incident delirium (HR 1.72, 1.10-2.70, p = 0.017) and dementia (HR 3.01, 95% CI 1.37-6.705, p = 0.017). Protective factors were concurrent use of angiotensin-converting enzyme inhibitors (HR 0.42, 95% CI 0.25-0.72, p = 0.002) or prescription of hydroxychloroquine (HC 0.37 95% CI 0.22-0.62, p < 0.001) treatment during admission.

Conclusions and implications: Our findings suggest that recognition of geriatric syndromes together with the CURB-65 score may be useful tools to help clinicians establish the prognosis of oldest-old patients admitted to hospital with COVID-19.

Keywords: Covid-19; Mortality; Older adults; Risk factors; SARS-COV-2.

PubMed Disclaimer

Conflict of interest statement

The authors have declared no conflict of interest for this article and no financial conflicts.

Figures

Fig. 1
Fig. 1
Kaplan–Meier survival curves Delirium (Long-Rank: p = 0.001)
Fig. 2
Fig. 2
Kaplan–Meier survival curves CURB-65 (Long-Rank: p < 0.001)
See this image and copyright information in PMC

References

    1. Dong E, Du H, Gardner L. An interactive web-based dashboard to track COVID-19 in real time. Lancet Inf Dis. 2020;20(5):533–534. doi: 10.1016/S1473-3099(20)30120-1. - DOI - PMC - PubMed
    1. European monitoring of excess mortality for public health action. http://www.euromomo.eu/. Accessed 13 Feb 2021
    1. Rodriguez-Nava G, Yanez-Bello MA, Trelles-Garcia DP, Chung CW, Chaudry S, Khan AS, et al. Clinical characteristics and risk factors for death of hospitalized patients with COVID-19 in a community hospital: a retrospective cohort study. Mayo Clin Proc Innov Qual Outcomes. 2020;5(1):1–10. doi: 10.1016/j.mayocpiqo.2020.10.007. - DOI - PMC - PubMed
    1. Martín-Sánchez FJ, Del Toro E, Cardassay E, Valls Carbó A, Cuesta F, Vigara M, et al. Clinical presentation and outcome across age categories among patients with COVID-19 admitted to a Spanish Emergency Department. Eur Geriatr Med. 2020;11(5):829–841. doi: 10.1007/s41999-020-00359-2. - DOI - PMC - PubMed
    1. Yang J, Zheng Y, Gou X, Pu K, Chen Z, Guo Q, et al. Prevalence of comorbidities and its effects in patients infected with SARS-CoV-2: a systematic review and meta-analysis. Int J Infect Dis. 2020;94:91–95. doi: 10.1016/j.ijid.2020.03.017. - DOI - PMC - PubMed

Publication types