Association between Clinical Frailty Scale score and hospital mortality in adult patients with COVID-19 (COMET): an international, multicentre, retrospective, observational cohort study
Roos S. G. Sablerolles, Melvin Lafeber, Janneke A. L. van Kempen, Bob P. A. van de Loo, Eric Boersma, Wim J. R. Rietdijk, Harmke A. Polinder‐Bos, Simon P. Mooijaart, Hugo van der Kuy, Jorie Versmissen, Miriam C. Faes, Laura Agnoletto, J Aleman, Silvia Andreassi, Louise M. Andrews, L Ashfield, Heather Elizabeth Bell, AKB Bengaard, SB Berlinghini, KB Bini, ZB Bisoffi, KB Blum, E Boemaars, GB Boni, Tessa M. Bosch, B.E. Bosma, F Boutkourt, Celestino Bufarini, Arjan Bulsink, RC Cabuk, GC Callens, M Ibáñez Candela, MC Canonici, EC Capone, IC Carmo, FC Caruso, PC Chessa, GC Cohet, I Cornelissen-Wesseling, KML Crommentuijn, FM de Stoppelaar, HAJM De Wit, DS Deben, L. Derijks, MDC Di Carlo, Jeroen Diepstraten, Burcu Dilek, DMK Duchek-Mann, MM Ebbens, LJ Ellerbroek, Marieke Ezinga, MF Falcao, FF Falcao, LF Fantini, Helena Farinha, P. Margreet G. Filius, NJ Fitzhugh, G Fleming, TF Forsthuber, GG Gambarelli, MG Gambera, CGY García Yubero, Z Getrouw, CN Ghazarian, Nicola Goodfellow, MQG Gorgas, RG Grinta, Kishore Guda, DH Haider, Janet Hanley, KH Heitzeneder, WL Hemminga, LC Hendriksen, DL Hilarius, FEF Hogenhuis, IC Hoogendoorn-de Graaf, MBH Houlind, MAH Huebler, KPGM Hurkens, PKC Janssen, Eline de Jong, MHW Kappers, KFM Keijzers, MK Kemogni, EM Kemper, RA Kranenburg, LL Krens, JL G Le Grand, Jing Liang, Stephen Lim, NL Lindner, EL Loche, AL Lubich, Barbara Maat, CM Maesano, AM Maiworm, Marilena Maragna, FM Marchesini, IM Martignoni, G. Martini
Abstract
BACKGROUND: During the COVID-19 pandemic, the scarcity of resources has necessitated triage of critical care for patients with the disease. In patients aged 65 years and older, triage decisions are regularly based on degree of frailty measured by the Clinical Frailty Scale (CFS). However, the CFS could also be useful in patients younger than 65 years. We aimed to examine the association between CFS score and hospital mortality and between CFS score and admission to intensive care in adult patients of all ages with COVID-19 across Europe. METHODS: ). The primary outcome was hospital mortality. The secondary outcome was admission to intensive care. Data were analysed using a multivariable binary logistic regression model adjusted for covariates (age, sex, number of drugs prescribed, and type of drug class as a proxy for comorbidities). FINDINGS: OR 0·66 [0·47-0·93], p=0·018). INTERPRETATION: The results of this study suggest that CFS score is a suitable risk marker for hospital mortality in adult patients with COVID-19. However, treatment decisions based on the CFS in patients younger than 65 years should be made with caution. FUNDING: LOEY Foundation.