Background: Coronavirus disease 2019 (COVID-19) has a substantial mortality risk with increased rates in the elderly. We hypothesized that age is not sufficient, and that frailty measured by preadmission Palliative Performance Scale would be a predictor of outcomes. Improved ability to identify high-risk patients will improve clinicians’ ability to provide appropriate palliative care, including engaging in shared decision-making about life-sustaining therapies. Aim: To evaluate whether preadmission Palliative Performance Scale predicts mortality in hospitalized patients with COVID-19. Design: Retrospective observational cohort study of patients admitted with COVID-19. Palliative Performance Scale was calculated from the chart. Using logistic regression, Palliative Performance Scale was assessed as a predictor of mortality controlling for demographics, comorbidities, palliative care measures and socioeconomic status. Setting/participants: Patients older than 18 years of age admitted with COVID-19 to a single urban public hospital in New Jersey, USA. Results: Of 443 admitted patients, we determined the Palliative Performance Scale score for 374. Overall mortality was 31% and 81% in intubated patients. In all, 36% (134) of patients had a low Palliative Performance Scale score. Compared with patients with a high score, patients with a low score were more likely to die, have do not intubate orders and be discharged to a facility. Palliative Performance Scale independently predicts mortality (odds ratio 2.89; 95% confidence interval 1.42–5.85). Conclusions: Preadmission Palliative Performance Scale independently predicts mortality in patients hospitalized with COVID-19. Improved predictors of mortality can help clinicians caring for patients with COVID-19 to discuss prognosis and provide appropriate palliative care including decisions about life-sustaining therapy.
【저자키워드】 coronavirus, frailty, Palliative care, Hospital mortality, physical functional performance, 【초록키워드】 COVID-19, Coronavirus disease 2019, therapy, Mortality, Prognosis, hospital, Comorbidities, outcomes, Patient, Logistic regression, age, predictor, scale, USA, performance, patients, predict, Therapies, mortality risk, Odds ratio, demographics, Observational cohort study, do not intubate, clinician, 95% confidence interval, help, measure, intubated patients, high-risk patient, palliative, IMPROVE, identify, evaluate, calculated, hospitalized patient, discharged, Improved, New, patients hospitalized, patients with COVID-19, with COVID-19, 【제목키워드】 Mortality, scale, performance, predict, palliative, hospitalized patient, with COVID-19,