Impact of functional dependency of elderly patients seen in Spanish emergency departments during the first wave of the COVID-19 pandemic on mortality at 30, 180 and 365 days depending on the diagnosis (COVID versus non-COVID).

被引：0

作者：

Fernandez Alonso, Cesareo ^{[1
]}

Fuentes Ferrer, Manuel E. ^{[2
]}

Garcia-Lamberechts, Eric Jorge ^{[1
]}

Aguilo Mir, Sira ^{[3
]}

Jimenez, Sonia ^{[3
]}

Jacob Rodriguez, Javier ^{[4
]}

Pinera Salmeron, Pascual ^{[5
]}

Gil-Rodrigo, Adriana ^{[6
]}

Llorens, Pere ^{[6
]}

Burillo-Putze, Guillermo ^{[7
]}

Montero Perez, Francisco Javier ^{[8
]}

Alquezar-Arbe, Aitor ^{[9
]}

Rios Gallardo, Rafaela ^{[10
]}

Berenguer Diez, Maria Amparo ^{[11
]}

Truyol Mas, Marina ^{[12
]}

Lopez-Laguna, Nieves ^{[13
]}

Cortes Soler, Alejandro ^{[14
]}

Gonzalez Nespereira, Emma ^{[15
]}

Garcia Garcia, Angel ^{[16
]}

Ezponda, Patxi ^{[17
]}

Martinez Lorenzo, Andrea ^{[18
]}

Ortega Liarte, Juan Vicente ^{[19
]}

Santos Martin, Jose Maria ^{[20
]}

Herrero Puente, Pablo ^{[21
]}

Melcon Villalibre, Alejandro ^{[1
]}

Gonzalez del Castillo, Juan ^{[1
]}

Miro, Oscar ^{[3
]}

机构：

[1] Univ Complutense, Serv Urgencias, Hosp Clin San Carlos, IDISSC, Madrid, Spain

[2] Hosp Univ Nuestra Senora Candelaria, Unidad Invest, Santa Cruz De Tenerife, Spain

[3] Univ Barcelona, Area Urgencias, IDIBAPS, Hosp Clin, Barcelona, Spain

[4] Hosp Univ Bellvitge, Serv Urgencias, Lhospitalet De Llobregat, Barcelona, Spain

[5] Hosp Reina Sofia, Serv Urgencias, Murcia, Spain

[6] Univ Miguel Hernandez, Hosp Doctor Balmis Alicante, Inst Invest Sanitaria & Biomed Alicante ISABIAL, Serv Urgencias,Unidad Estancia Corta & Hospitaliz, Alicante, Spain

[7] Univ Europea Canarias, Fac Ciencias Salud, Santa Cruz De Tenerife, Spain

[8] Hosp Reina Sofia, Serv Urgencias, Cordoba, Spain

[9] Hosp Santa Creu & Sant Pau, Serv Urgencias, Barcelona, Spain

[10] Hosp Virgen del Rocio, Servi Urgencias, Seville, Spain

[11] Hosp Gen Univ Dr Peset, Serv Urgencias, Valencia, Spain

[12] Hosp Univ Son Espases, Serv Urgencias, Palma De Mallorca, Spain

[13] Clin Univ Navarra, Serv Urgencias, Madrid, Spain

[14] Hosp Clin Univ Valencia, Serv Urgencias, Valencia, Spain

[15] Hosp Alvaro Cunqueiro, Serv Urgencias, Vigo, Spain

[16] Hosp Univ Salamanca, Serv Urgencias, Salamanca, Spain

[17] Hosp Zumarraga, Serv Urgencias, Zumarraga, Spain

[18] Hosp Virxe Xunqueira, Serv Urgencias, La Coruna, Spain

[19] Hosp Univ Arcos del Mar Menor, Serv Urgencias, Murcia, Spain

[20] Hosp Juan Ramon Jimenez, Serv Urgencias, Huelva, Spain

[21] Hosp Cent Asturias, Serv Urgencias, Oviedo, Spain

来源：

REVISTA ESPANOLA DE SALUD PUBLICA | 2023年 / 97卷

关键词：

Hospital Emergencies; Functional dependence; First wave of the pandemic; Mortality at 30; 180; and; 365; days; OLDER PATIENTS; CARE; RISK; OUTCOMES; EDEN;

D O I：

暂无

中图分类号：

R1 [预防医学、卫生学];

学科分类号：

1004 ; 120402 ;

摘要：

BACKGROUND // Functional assessment is part of geriatric assessment. How it is performed in hospital Emergency Departments (ED) is poorly understood, let alone its prognostic value. The aim of this paper was to investigate whether baseline disability to perform basic activities of daily living (BADL) was an independent prognostic factor for death after the index visit to the ED during the first wave of the COVID-19 pandemic and whether it had a different impact on patients with and without diagnosis of COVID-19.METHODS // A retrospective observational study of the EDEN-Covid (Emergency Department and Elder Needs during COVID) cohort was carried out, consisting of all patients aged >= 65 years seen in 52 Spanish EDs selected by chance during 7 consecutive days (30/3/2020 to 5/4/2020). Demographic, clinical, functional, mental and social variables were analyzed. Dependence was categorized with the Barthel index (BI) as independent (BI=100), mild-moderate dependence (100>BI>60) and severe-total dependence (BI<60), and their crude and adjusted association was evaluated with mortality at 30, 180 and 365 days using COX proportional hazards models.RESULTS // Of 9,770 enrolled patients with a mean age of 79 years, 51% were men, 6,305 (64.53%) were independent, 2,340 (24%) had mild-moderate dependence, and 1,125 (11.5%) severe-total dependence. The number of deaths at 30 days in these three groups was 500 (7.9%), 521 (22.3%) and 378 (33.6%), respectively; at 180 days it was 757 (12%), 725 (30.9%) and 526 (46.8%); and at 365 days 954 (15.1%), 891 (38.1%) and 611 (54.3%). In relation to independent patients, the adjusted risks (hazard ratio) of dying within 30 days associated with mild-moderate and severe-total dependency were 1.91 (95% CI: 1.66-2.19) and 2.51. (2.11-2.98); at 180 days they were 1.88 (1.68-2.11) and 2.64 (2.28-3.05); and at 365 days they were 1.82 (1.64-2.02) and 2.47 (2.17-2.82). This negative impact of dependency on mortality was greater in patients diagnosed with COVID-19 than in non-COVID-19 (p interaction at 30, 180 and 365 days of 0.36, 0.05 and 0.04).CONCLUSIONS //The functional dependence of older patients who attend Spanish EDs during the first wave of the pandemic is associated with mortality at 30, 180 and 365 days, and this risk is significantly higher in patients treated for COVID-19.

引用

页数：19