Clinical Features and Risk Factors for Mortality Among Long-term Care Facility Residents Hospitalized Due to COVID-19 in Spain.

BACKGROUND: COVID-19 severely impacted older adults and long-term care facility (LTCF) residents. Our primary aim was to describe differences in clinical and epidemiological variables, in-hospital management, and outcomes between LTCF residents and community-dwelling older adults hospitalized with C...

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Autores: Ramos-Rincón JM, Bernabeu-Wittel M, Fiteni-Mera I, López-Sampalo A, López-Ríos C, García-Andreu MD, Mancebo-Sevilla JJ, Jiménez-Juan C, Matía-Sanz M, López-Quirantes P, Rubio-Rivas M, Paredes-Ruiz D, González-San-Narciso C, González-Vega R, Sanz-Espinosa P, Hernández-Milián A, Gonzalez-Noya A, Gil-Sánchez R, Boixeda R, Alcalá-Pedrajas JN, Palop-Cervera M, Cortés-Rodríguez B, Guisado-Espartero ME, Mella-Pérez C, Gómez-Huelgas R
Formato: artículo
Estado:Versión publicada
Fecha de publicación:2022
País:España
Recursos:Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL)
Repositorio:r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
OAI Identifier:oai:isabial.fundanetsuite.com:p8836
Acesso em linha:https://isabial.portalinvestigacion.com/publicaciones8836
https://academic.oup.com/biomedgerontology/article/77/4/e138/6385886?login=true
Access Level:acceso abierto
Palavra-chave:COVID-19
Epidemiology
Mortality
Nursing homes
Risk factors
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spelling Clinical Features and Risk Factors for Mortality Among Long-term Care Facility Residents Hospitalized Due to COVID-19 in Spain.Ramos-Rincón JMBernabeu-Wittel MFiteni-Mera ILópez-Sampalo ALópez-Ríos CGarcía-Andreu MDMancebo-Sevilla JJJiménez-Juan CMatía-Sanz MLópez-Quirantes PRubio-Rivas MParedes-Ruiz DGonzález-San-Narciso CGonzález-Vega RSanz-Espinosa PHernández-Milián AGonzalez-Noya AGil-Sánchez RBoixeda RAlcalá-Pedrajas JNPalop-Cervera MCortés-Rodríguez BGuisado-Espartero MEMella-Pérez CGómez-Huelgas RCOVID-19EpidemiologyMortalityNursing homesRisk factorsBACKGROUND: COVID-19 severely impacted older adults and long-term care facility (LTCF) residents. Our primary aim was to describe differences in clinical and epidemiological variables, in-hospital management, and outcomes between LTCF residents and community-dwelling older adults hospitalized with COVID-19. The secondary aim was to identify risk factors for mortality due to COVID-19 in hospitalized LTCF residents. METHODS: This is a cross-sectional analysis within a retrospective cohort of hospitalized patients =75 years with confirmed COVID-19 admitted to 160 Spanish hospitals. Differences between groups and factors associated with mortality among LTCF residents were assessed through comparisons and logistic regression analysis. RESULTS: Of 6 189 patients =75 years, 1 185 (19.1%) were LTCF residents and 4 548 (73.5%) were community-dwelling. LTCF residents were older (median: 87.4 vs 82.1 years), mostly female (61.6% vs 43.2%), had more severe functional dependence (47.0% vs 7.8%), more comorbidities (Charlson Comorbidity Index: 6 vs 5), had dementia more often (59.1% vs 14.4%), and had shorter duration of symptoms (median: 3 vs 6 days) than community-dwelling patients (all, p < .001). Mortality risk factors in LTCF residents were severe functional dependence (adjusted odds ratios [aOR]: 1.79; 95% confidence interval [CI]: 1.13-2.83; p = .012), dyspnea (1.66; 1.16-2.39; p = .004), SatO2 < 94% (1.73; 1.27-2.37; p = .001), temperature = 37.8°C (1.62; 1.11-2.38; p = .013); qSOFA index = 2 (1.62; 1.11-2.38; p = .013), bilateral infiltrates (1.98; 1.24-2.98; p < .001), and high C-reactive protein (1.005; 1.003-1.007; p < .001). In-hospital mortality was initially higher among LTCF residents (43.3% vs 39.7%), but lower after adjusting for sex, age, functional dependence, and comorbidities (aOR: 0.74, 95%CI: 0.62-0.87; p < .001). CONCLUSION: Basal functional status and COVID-19 severity are risk factors of mortality in LTCF residents. The lower adjusted mortality rate in LTCF residents may be explained by earlier identification, treatment, and hospitalization for COVID-19.OXFORD UNIV PRESS INC2022info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://isabial.portalinvestigacion.com/publicaciones8836https://academic.oup.com/biomedgerontology/article/77/4/e138/6385886?login=trueJOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCESISSN: 10795006ISSNe: 1758535Xreponame:r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicanteinstname:Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL)Inglésinfo:eu-repo/semantics/openAccessoai:isabial.fundanetsuite.com:p88362026-06-12T10:20:37Z
dc.title.none.fl_str_mv Clinical Features and Risk Factors for Mortality Among Long-term Care Facility Residents Hospitalized Due to COVID-19 in Spain.
title Clinical Features and Risk Factors for Mortality Among Long-term Care Facility Residents Hospitalized Due to COVID-19 in Spain.
spellingShingle Clinical Features and Risk Factors for Mortality Among Long-term Care Facility Residents Hospitalized Due to COVID-19 in Spain.
Ramos-Rincón JM
COVID-19
Epidemiology
Mortality
Nursing homes
Risk factors
title_short Clinical Features and Risk Factors for Mortality Among Long-term Care Facility Residents Hospitalized Due to COVID-19 in Spain.
title_full Clinical Features and Risk Factors for Mortality Among Long-term Care Facility Residents Hospitalized Due to COVID-19 in Spain.
title_fullStr Clinical Features and Risk Factors for Mortality Among Long-term Care Facility Residents Hospitalized Due to COVID-19 in Spain.
title_full_unstemmed Clinical Features and Risk Factors for Mortality Among Long-term Care Facility Residents Hospitalized Due to COVID-19 in Spain.
title_sort Clinical Features and Risk Factors for Mortality Among Long-term Care Facility Residents Hospitalized Due to COVID-19 in Spain.
dc.creator.none.fl_str_mv Ramos-Rincón JM
Bernabeu-Wittel M
Fiteni-Mera I
López-Sampalo A
López-Ríos C
García-Andreu MD
Mancebo-Sevilla JJ
Jiménez-Juan C
Matía-Sanz M
López-Quirantes P
Rubio-Rivas M
Paredes-Ruiz D
González-San-Narciso C
González-Vega R
Sanz-Espinosa P
Hernández-Milián A
Gonzalez-Noya A
Gil-Sánchez R
Boixeda R
Alcalá-Pedrajas JN
Palop-Cervera M
Cortés-Rodríguez B
Guisado-Espartero ME
Mella-Pérez C
Gómez-Huelgas R
author Ramos-Rincón JM
author_facet Ramos-Rincón JM
Bernabeu-Wittel M
Fiteni-Mera I
López-Sampalo A
López-Ríos C
García-Andreu MD
Mancebo-Sevilla JJ
Jiménez-Juan C
Matía-Sanz M
López-Quirantes P
Rubio-Rivas M
Paredes-Ruiz D
González-San-Narciso C
González-Vega R
Sanz-Espinosa P
Hernández-Milián A
Gonzalez-Noya A
Gil-Sánchez R
Boixeda R
Alcalá-Pedrajas JN
Palop-Cervera M
Cortés-Rodríguez B
Guisado-Espartero ME
Mella-Pérez C
Gómez-Huelgas R
author_role author
author2 Bernabeu-Wittel M
Fiteni-Mera I
López-Sampalo A
López-Ríos C
García-Andreu MD
Mancebo-Sevilla JJ
Jiménez-Juan C
Matía-Sanz M
López-Quirantes P
Rubio-Rivas M
Paredes-Ruiz D
González-San-Narciso C
González-Vega R
Sanz-Espinosa P
Hernández-Milián A
Gonzalez-Noya A
Gil-Sánchez R
Boixeda R
Alcalá-Pedrajas JN
Palop-Cervera M
Cortés-Rodríguez B
Guisado-Espartero ME
Mella-Pérez C
Gómez-Huelgas R
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv COVID-19
Epidemiology
Mortality
Nursing homes
Risk factors
topic COVID-19
Epidemiology
Mortality
Nursing homes
Risk factors
description BACKGROUND: COVID-19 severely impacted older adults and long-term care facility (LTCF) residents. Our primary aim was to describe differences in clinical and epidemiological variables, in-hospital management, and outcomes between LTCF residents and community-dwelling older adults hospitalized with COVID-19. The secondary aim was to identify risk factors for mortality due to COVID-19 in hospitalized LTCF residents. METHODS: This is a cross-sectional analysis within a retrospective cohort of hospitalized patients =75 years with confirmed COVID-19 admitted to 160 Spanish hospitals. Differences between groups and factors associated with mortality among LTCF residents were assessed through comparisons and logistic regression analysis. RESULTS: Of 6 189 patients =75 years, 1 185 (19.1%) were LTCF residents and 4 548 (73.5%) were community-dwelling. LTCF residents were older (median: 87.4 vs 82.1 years), mostly female (61.6% vs 43.2%), had more severe functional dependence (47.0% vs 7.8%), more comorbidities (Charlson Comorbidity Index: 6 vs 5), had dementia more often (59.1% vs 14.4%), and had shorter duration of symptoms (median: 3 vs 6 days) than community-dwelling patients (all, p < .001). Mortality risk factors in LTCF residents were severe functional dependence (adjusted odds ratios [aOR]: 1.79; 95% confidence interval [CI]: 1.13-2.83; p = .012), dyspnea (1.66; 1.16-2.39; p = .004), SatO2 < 94% (1.73; 1.27-2.37; p = .001), temperature = 37.8°C (1.62; 1.11-2.38; p = .013); qSOFA index = 2 (1.62; 1.11-2.38; p = .013), bilateral infiltrates (1.98; 1.24-2.98; p < .001), and high C-reactive protein (1.005; 1.003-1.007; p < .001). In-hospital mortality was initially higher among LTCF residents (43.3% vs 39.7%), but lower after adjusting for sex, age, functional dependence, and comorbidities (aOR: 0.74, 95%CI: 0.62-0.87; p < .001). CONCLUSION: Basal functional status and COVID-19 severity are risk factors of mortality in LTCF residents. The lower adjusted mortality rate in LTCF residents may be explained by earlier identification, treatment, and hospitalization for COVID-19.
publishDate 2022
dc.date.none.fl_str_mv 2022
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://isabial.portalinvestigacion.com/publicaciones8836
https://academic.oup.com/biomedgerontology/article/77/4/e138/6385886?login=true
url https://isabial.portalinvestigacion.com/publicaciones8836
https://academic.oup.com/biomedgerontology/article/77/4/e138/6385886?login=true
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv OXFORD UNIV PRESS INC
publisher.none.fl_str_mv OXFORD UNIV PRESS INC
dc.source.none.fl_str_mv JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES
ISSN: 10795006
ISSNe: 1758535X
reponame:r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
instname:Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL)
instname_str Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL)
reponame_str r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
collection r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
repository.name.fl_str_mv
repository.mail.fl_str_mv
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