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      Variables asociadas a mortalidad en una población de pacientes mayores de 80 años y con algún grado de dependencia funcional hospitalizados por COVID-19 en un Servicio de Geriatría Translated title: Variables associated with mortality in a selected sample of patients older than 80 years and with some degree of functional dependence hospitalized for COVID-19 in a Geriatrics Service.

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          RESUMEN

          Antecedentes y objetivo: La pandemia por SARS-CoV-2 condiciona elevadas tasas de mortalidad en pacientes mayores hospitalizados. Actualmente, pocos estudios incluyen pacientes octogenarios y ninguno analiza el impacto del estado funcional sobre este resultado de salud. Nuestro objetivo es describir las características de los pacientes mayores de 80 años hospitalizados por “coronavirus disease 2019” (COVID-19), determinar la tasa de mortalidad e identificar factores asociados.

          Materiales y métodos: estudio observacional prospectivo realizado en mayores de 80 años ingresados por COVID-19 en un Servicio de Geriatría. Se recogieron variables sociodemográficas, clínicas, funcionales, mentales, analíticas, radiológicas, terapéuticas y asistenciales. Se analizaron mediante análisis bivariante los factores asociados a mortalidad intrahospitalaria.

          Resultados: fueron incluidos 58 casos con COVID-19 confirmado por laboratorio, edad media 88,3±5,4 años, 69% mujeres, 65,5% deterioro cognitivo moderado-severo e índice de Barthel previo 40,6±36. Los principales síntomas fueron fiebre (60,3%), disnea (53,4%) y deterioro del estado funcional (50%). Las comorbilidades más frecuentes fueron enfermedad cardiovascular (75,9%), hipertensión arterial (HTA) (74,1%) y enfermedad renal crónica (ERC) (50%). Se detectó una tasa de mortalidad del 41,4%, siendo los factores asociados: dependencia funcional severa (OR=3,8 [1,2-12,2]), ERC (OR=3,2 [1,1-9,7]), deterioro cognitivo moderado-severo (OR=4,9 [1 a 25,4]).

          Conclusiones: Se objetivan altas tasas de mortalidad en pacientes mayores hospitalizados por COVID-19, con mayor riesgo de fallecer en aquellos con dependencia funcional severa o deterioro cognitivo. Estos hallazgos refuerzan la importancia de la Valoración Geriátrica para elaborar estrategias que permitan adecuar la toma de decisiones diagnósticas y terapéuticas y optimizar la atención al paciente anciano ante un nuevo brote epidémico.

          Translated abstract

          Objective: The SARS-CoV-2 pandemic conditions high mortality rates in hospitalized elderly. Currently, a few studies include octogenarian patients and none of them analyze the impact of functional status on this health outcome. Our objective is to describe the characteristics of patients older than 80 years hospitalized for “coronavirus disease 2019” (COVID-19), to determine the mortality rate and to identify associated factors.

          Material and methods: Prospective observational study carried out on patients over 80 years admitted for COVID-19 in a Geriatrics Service. Sociodemographic, clinical, functional, mental, analytical, radiological, therapeutic and healthcare variables were collected. The factors associated with in-hospital lethality were analyzed by bivariate analysis.

          Results: 58 cases with laboratory-confirmed COVID-19 were included, mean age 88,3±5,4 years, 69% women, 65,5% moderate-severe cognitive impairment and previous Barthel index 40,66±36. The main symptoms were fever (60,3%), dyspnea (53,4%) and deterioration of functional condition (50%). The most frequent comorbidities were cardiovascular disease (75,9%), hypertension (HT) (74,1%) and chronic kidney disease (CKD) (50%). A mortality rate of 41,4% was detected and the associated factors were: severe functional dependence (OR=3,8 [1,2-12,2]), moderate-severe cognitive impairment (OR= 4,9 [1-25,4]) and CKD (OR=3,2 [1,1-9,7]).

          Conclusion: High mortality rates are observed in older patients hospitalized for COVID-19, with a higher risk of dying in those with severe functional dependence or cognitive impairment. These findings reinforce the value of Geriatric Assessment to develop strategies to adapt diagnostic and therapeutic decision-making and to optimize care for elderly patients in the event of a new epidemic outbreak.

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          Author and article information

          Contributors
          Journal
          Rev Esp Geriatr Gerontol
          Rev Esp Geriatr Gerontol
          Revista Espanola De Geriatria Y Gerontologia
          SEGG. Published by Elsevier España, S.L.U.
          0211-139X
          1578-1747
          16 July 2020
          16 July 2020
          Affiliations
          [a ]Área de Gestión Clínica de Geriatría. Hospital Monte Naranco, Oviedo, Asturias, España
          [b ]Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Asturias, España
          Author notes
          [* ]Autor de correspondencia: jmonter92@ 123456gmail.com
          Article
          S0211-139X(20)30109-8
          10.1016/j.regg.2020.07.002
          7365050
          © 2020 SEGG. Published by Elsevier España, S.L.U. All rights reserved.

          Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

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