The impact of frailty on the outcomes of COVID-19 patients with persistent critical illness: A population-based cohort study

Abstract

AbstractObjectivesPersistent critical illness (PerCI, ≥10 days in Intensive Care Unit [ICU]) is defined as the time from ICU admission when patients’ antecedent characteristics define their mortality rather than the admission aetiology. Patients with frailty and without COVID-19 have a higher risk of developing and dying from PerCI. We aimed to investigate the impact of frailty on critically ill patients with COVID-19 experiencing PerCI.MethodsWe conducted a retrospective multicentre cohort study including 103 Australian and New Zealand ICUs over two years, investigating the impact of frailty, measured with Clinical Frailty Scale (CFS), in patients with COVID-19, between patients with and without PerCI.ResultsThe prevalence of PerCI was similar between patients with and without frailty (25.4% vs. 27.9%; p=0.44). Hospital mortality was higher in patients with PerCI than without (28.8% vs. 9.3%; p<0.001), with mortality rising with increasing CFS (p<0.001). Frailty independently predicted hospital mortality, but when adjusted for ANZROD and sex, its impact was no different in patients with and without PerCI (odds ratio [OR]=1.30 [95%-CI: 1.14-1.49] vs. OR=1.46 [95%-CI: 1.29-1.64]).ConclusionsThe presence of frailty independently predicted hospital mortality in patients with PerCI, but frailty did not have a different impact on patients with and without PerCI.