63 FRAILTY AND COVID-19 IN HOSPITALISED OLDER ADULTS

Abstract

Abstract Background Frailty is an important factor in clinical decision making for patients with COVID-19. In COVID-19, frailty can better predict outcomes than age or comorbidity. We aimed to establish the extent of frailty in a cohort of older adults admitted to an Irish hospital with COVID-19. Methods This is a retrospective observational study of frailty and outcomes in all patients over the age of 75 admitted to an Irish hospital between 01/03/20 - 31/10/20 who tested positive for SARS-CoV2 RNA on PCR during admission. This corresponded with the first wave of COVID-19. Frailty was assessed using the Rockwood Clinical Frailty Scale (CFS). Eligible patients’ charts were reviewed and a frailty score of 1 (very fit) to 9 (terminally ill) was assigned based on multidisciplinary assessment of pre-admission status. The outcomes assessed were length of stay, in-hospital mortality, and change in discharge destination i.e. patients admitted from home requiring discharge to long-term care. Results The 45 study participants had a median age of 83 years. 19 (42%) patients were female. The mean CFS on admission was 6, indicating moderate frailty. 12 (27%) patients were residents in long-term care. The average length of stay was 27 days. 14 (31%) patients died. Of these, the median age was 82 and the median clinical frailty score was 6.5. Death occurred in 5 (42%) patients admitted from long-term care and in 9 (27%) patients admitted from home. There was a change in discharge destination in 7 (29%) of the 24 patients who were admitted from home and survived the hospitalisation. Of these, the median clinical frailty score was 5. Conclusion Frailty was highly prevalent in this cohort of hospital in-patients with COVID-19. Frailty likely contributed to the high mortality and lengths of stay. Furthermore, this study highlights the harmful impact of COVID-19 by its association with high rates of discharge to long-term care in those who were admitted from home.