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. 2022 Oct;13(5):1149-1157.
doi: 10.1007/s41999-022-00668-8. Epub 2022 Jun 24.

The association between frailty risk and COVID-19-associated all-mortality in hospitalised older people: a national cohort study

Laia Maynou #  1   2   3 , Rhiannon Owen #  4 , Rob Konstant-Hambling  5 , Towhid Imam  6 , Suzanne Arkill  7 , Deborah Bertfield  8 , Andrew Street  9 , Keith R Abrams  10 , Simon Conroy  11
Affiliations

The association between frailty risk and COVID-19-associated all-mortality in hospitalised older people: a national cohort study

Laia Maynou et al. Eur Geriatr Med. 2022 Oct.

Erratum in

Abstract

Introduction: Frailty has emerged as an important construct to support clinical decision-making during the COVID-19 pandemic. However, doubts remain related to methodological limitations of published studies.

Methods: Retrospective cohort study of all people aged 75 + admitted to hospital in England between 1 March 2020 and 31 July 2021. COVID-19 and frailty risk were captured using International Classification of Disease-10 (ICD-10) diagnostic codes. We used the generalised gamma model to estimate accelerated failure time, reporting unadjusted and adjusted results.

Results: The cohort comprised 103,561 individuals, mean age 84.1, around half female, 82% were White British with a median of two comorbidities. Frailty risk was distributed approximately 20% low risk and 40% each at intermediate or high risk. In the unadjusted survival plots, 28-day mortality was almost 50% for those with an ICD-10 code of U071 (COVID-19 virus identified), and 25-35% for those with U072 (COVID-19 virus not identified). In the adjusted analysis, the accelerated failure time estimates for those with intermediate and high frailty risk were 0.63 (95% CI 0.58-0.68) and 0.67 (95% CI 0.62-0.72) fewer days alive respectively compared to those with low frailty risk with an ICD-10 diagnosis of U072 (reference category).

Conclusion: In older people with confirmed COVID-19, both intermediate and high frailty risk were associated with reduced survival compared to those with low frailty risk.

Keywords: Acute hospital outcomes; COVID-19; Frailty.

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Conflict of interest statement

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Figures

Fig. 1
Fig. 1
Kaplan–Meier plots showing time to all-cause deaths by HFRS category, stratified by ICD-10 code
Fig. 2
Fig. 2
Time ratios for unadjusted and adjusted models
See this image and copyright information in PMC

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