Functional decline in hospitalized older patients with coronavirus disease 2019: a retrospective cohort study

Abstract Background This study aimed to determine the frequency of functional decline and to identify the factors related to a greater risk of functional decline among hospitalized older patients with coronavirus disease 2019 (COVID-19). Methods We reviewed the medical records of patients aged over...

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Autores principales:	Tomohiro Hosoda, Shota Hamada
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Activities of daily living Barthel index Coronavirus disease 2019 Disability Functional decline Hospitalization Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/7ee4b44f9c704ee0a7ea99f4fb9856d1
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spelling	oai:doaj.org-article:7ee4b44f9c704ee0a7ea99f4fb9856d12021-11-14T12:11:11ZFunctional decline in hospitalized older patients with coronavirus disease 2019: a retrospective cohort study10.1186/s12877-021-02597-w1471-2318https://doaj.org/article/7ee4b44f9c704ee0a7ea99f4fb9856d12021-11-01T00:00:00Zhttps://doi.org/10.1186/s12877-021-02597-whttps://doaj.org/toc/1471-2318Abstract Background This study aimed to determine the frequency of functional decline and to identify the factors related to a greater risk of functional decline among hospitalized older patients with coronavirus disease 2019 (COVID-19). Methods We reviewed the medical records of patients aged over 65 years who were admitted to a tertiary care hospital for COVID-19 over 1 year from February 2020. We evaluated the proportion of functional decline, which was defined as a decrease in the Barthel Index score from before the onset of COVID-19 to discharge. Multivariable logistic regression analyses were performed to evaluate the associations between the demographic and clinical characteristics of patients at admission and a greater risk of functional decline. Two sensitivity analyses with different inclusion criteria were performed: one in patients without very severe functional decline before the onset of COVID-19 (i.e., limited to those with Barthel Index score ≥ 25), and the other with a composite outcome of functional decline and death at discharge. Results The study included 132 patients with COVID-19; of these, 72 (54.5%) developed functional decline. The severity of COVID-19 did not differ between patients with functional decline and those without (P = 0.698). Factors associated with a greater risk of functional decline included female sex (adjusted odds ratio [aOR], 3.14; 95% confidence interval [CI], 1.25 to 7.94), Barthel Index score < 100 before the onset of COVID-19 (aOR, 13.73; 95% CI, 3.29 to 57.25), and elevation of plasma D-dimer level on admission (aOR, 3.19; 95% CI, 1.12 to 9.07). The sensitivity analyses yielded similar results to those of the main analysis. Conclusions Over half of the older patients who recovered from COVID-19 developed functional decline at discharge from a tertiary care hospital in Japan. Baseline activities of daily living impairment, female sex, and elevated plasma D-dimer levels at admission were associated with a greater risk of functional decline.Tomohiro HosodaShota HamadaBMCarticleActivities of daily livingBarthel indexCoronavirus disease 2019DisabilityFunctional declineHospitalizationGeriatricsRC952-954.6ENBMC Geriatrics, Vol 21, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Activities of daily living Barthel index Coronavirus disease 2019 Disability Functional decline Hospitalization Geriatrics RC952-954.6
spellingShingle	Activities of daily living Barthel index Coronavirus disease 2019 Disability Functional decline Hospitalization Geriatrics RC952-954.6 Tomohiro Hosoda Shota Hamada Functional decline in hospitalized older patients with coronavirus disease 2019: a retrospective cohort study
description	Abstract Background This study aimed to determine the frequency of functional decline and to identify the factors related to a greater risk of functional decline among hospitalized older patients with coronavirus disease 2019 (COVID-19). Methods We reviewed the medical records of patients aged over 65 years who were admitted to a tertiary care hospital for COVID-19 over 1 year from February 2020. We evaluated the proportion of functional decline, which was defined as a decrease in the Barthel Index score from before the onset of COVID-19 to discharge. Multivariable logistic regression analyses were performed to evaluate the associations between the demographic and clinical characteristics of patients at admission and a greater risk of functional decline. Two sensitivity analyses with different inclusion criteria were performed: one in patients without very severe functional decline before the onset of COVID-19 (i.e., limited to those with Barthel Index score ≥ 25), and the other with a composite outcome of functional decline and death at discharge. Results The study included 132 patients with COVID-19; of these, 72 (54.5%) developed functional decline. The severity of COVID-19 did not differ between patients with functional decline and those without (P = 0.698). Factors associated with a greater risk of functional decline included female sex (adjusted odds ratio [aOR], 3.14; 95% confidence interval [CI], 1.25 to 7.94), Barthel Index score < 100 before the onset of COVID-19 (aOR, 13.73; 95% CI, 3.29 to 57.25), and elevation of plasma D-dimer level on admission (aOR, 3.19; 95% CI, 1.12 to 9.07). The sensitivity analyses yielded similar results to those of the main analysis. Conclusions Over half of the older patients who recovered from COVID-19 developed functional decline at discharge from a tertiary care hospital in Japan. Baseline activities of daily living impairment, female sex, and elevated plasma D-dimer levels at admission were associated with a greater risk of functional decline.
format	article
author	Tomohiro Hosoda Shota Hamada
author_facet	Tomohiro Hosoda Shota Hamada
author_sort	Tomohiro Hosoda
title	Functional decline in hospitalized older patients with coronavirus disease 2019: a retrospective cohort study
title_short	Functional decline in hospitalized older patients with coronavirus disease 2019: a retrospective cohort study
title_full	Functional decline in hospitalized older patients with coronavirus disease 2019: a retrospective cohort study
title_fullStr	Functional decline in hospitalized older patients with coronavirus disease 2019: a retrospective cohort study
title_full_unstemmed	Functional decline in hospitalized older patients with coronavirus disease 2019: a retrospective cohort study
title_sort	functional decline in hospitalized older patients with coronavirus disease 2019: a retrospective cohort study
publisher	BMC
publishDate	2021
url	https://doaj.org/article/7ee4b44f9c704ee0a7ea99f4fb9856d1
work_keys_str_mv	AT tomohirohosoda functionaldeclineinhospitalizedolderpatientswithcoronavirusdisease2019aretrospectivecohortstudy AT shotahamada functionaldeclineinhospitalizedolderpatientswithcoronavirusdisease2019aretrospectivecohortstudy
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Functional decline in hospitalized older patients with coronavirus disease 2019: a retrospective cohort study

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