Clinical Frailty Scale is useful in predicting return-to-home in patients admitted due to coronavirus disease

Abstract

Abstract Background: The spread of the novel SARS-CoV-2 infection prolonged, and the highly contagious Omicron variant became the predominant variant by 2022. Many patients admitted to dedicated coronavirus disease 2019 (COVID-19) wards (COVID-19 Treatment Units) develop disuse syndrome while being treated in hospital, and their ability to perform activities of daily living decline, making it difficult for hospitals to discharge such patients. This study aimed to investigate the relationship between the degree of frailty and home discharge of patients admitted to a COVID-19 Treatment Unit. Methods: The study retrospectively examined the in-patient medical records of 138 patients (82.7±7.6 years) admitted to a COVID-19 Treatment Unit from January to December 2022. The endpoint was whether the patients were able to be discharged from the COVID-19 Treatment Unit directly to home, and were classified into the Home discharge group, compared with the Difficulty in discharge group. The degree of frailty was determined based on Clinical Frailty Scale (CFS), and the relationship with the endpoint was analysed. A Receiver Operating Characteristic (ROC) curve was created and the cut-off value was calculated with the possibility of home discharge set as the state variable and CFS set as the test variable. Logistic regression analysis was conducted with the possibility of home discharge set as the dependent variable and CFS as the independent variable. Results: There were 75 patients in the Home discharge group, and 63 patients in the Difficulty in discharge group. As a result of ROC analysis, the CFS cut-off value was 6 or more, with a sensitivity of 70.7% and specificity of 84.1%. The results of logistic regression analysis showed a significant correlation between possibility of home discharge and CFS even after adjusting for covariates, with an odds ratio of 13.44. Conclusions: It was possible to predict with good accuracy whether a patient could be discharged directly to home after treatment based on the evaluation of the degree of frailty in the COVID-19 Treatment Unit. CFS is effective as a screening tool that can easily detect patients who require ongoing hospitalisation even after the acute phase of treatment in the COVID-19 Treatment Unit.