Prognostic Factors of Mortality in Hospitalized Elderly with COVID-19: A Retrospective Study of Mortality Risk Stratification in Elderly with COVID-19
نویسندگان
1 Division of Respirology and Critical Care Internal Medicine, Departement of Internal Medicine, Faculty of Medicine, Universitas Indonesia/ dr. Cipto Mangunkusumo General Hospital, Indonesia
2 Clinical Epidemiology Unit, Departement of Internal Medicine, Faculty of Medicine, Universitas Indonesia/ dr. Cipto Mangunkusumo General Hospital, Indonesia
3 Division of Geriatric, Departement of Internal Medicine, Faculty of Medicine, Universitas Indonesia/ dr. Cipto Mangunkusumo General Hospital, Indonesia
4 Subspecialty of Geriatric Education Program, Departement of Internal Medicine, Faculty of Medicine, Universitas Indonesia/ dr. Cipto Mangunkusumo General Hospital, Indonesia
5 Division of Geriatric, Departement of Internal Medicine, Faculty of Medicine, Universitas Indonesia/ dr. Cipto Mangunkusumo General Hospital, Indonesia
6 Clinical Epidemiology Unit, Departement of Internal Medicine, Faculty of Medicine, Universitas Indonesia/ dr. Cipto Mangunkusumo General Hospital, Indonesia
7 Division of Endocrine Metabolic and Diabetes, Departement of Internal Medicine, Faculty of Medicine, Universitas Indonesia/ dr. Cipto Mangunkusumo General Hospital, Indonesia
8 Division of Psychosomatic and Palliative, Departement of Internal Medicine, Faculty of medicine, Universitas Indonesia/ dr. Cipto Mangunkusumo General Hospital, Indonesia
doi
10.26655/JMCHEMSCI.2025.2.8چکیده
Elderly is one of the high risk mortality population during COVID-19. Studies showed diverse factors that affect mortality in elderly worldwide. Atypical symptoms and the isolation during hospitalization were also potentially brought another new problem for the elderly. The aim of this study was to find out the incidence and prognostic factors of mortality in elderly with COVID-19 during hospitalization and develop the prognostic scoring systems expected to help in the management of elderly with COVID-19 in Indonesia This is a cohort retrospective study using medical record patients age ≥ 60 y.o hospitalized in Dr. Cipto Mangunkusumo Hospital between Mei 2021 and April 2022. The prognostic scoring system developed from the multivariate analysis with Cox proportional hazard regression result were then tested for its performance and internal validation. From 600 patients met the criteria, the mortality rate were 36.67% (CI95% 36.63-36.70) and the prognostic factors that affect the mortality were altered mental status (HR 1.604, p=0.004), functional status (total dependency HR 3.363, p=0.002; partial dependency HR 2.164, p=0.041), oxygen saturation <93% (HR 1.918, p<0.0001), Neutrophil to Lymphocyte Ratio ≥ 7 (HR 1.466, p=0.011), renal function (eGFR 30-60 HR 1.173, p=0.347; eGFR <30 HR 1.916, p<0.0001), C-Reactive Protein level ≥68.9 mg/L (HR1,779, p<0.0001), thrombocytopenia (HR 1.447, p=0.037), and nutritional status (Malnutrition Screening Tools score ≥ 2, HR 1.444, p=0.023). The prognostic scoring system developed had good performance with Hosmer Lemeshow test p=0.489 and AUC 0.833 (CI95% 0.801-0.865, p<0.0001). The mortality rate was 36.67% and the prognostic factors of mortality in elderly with COVID-19 were altered mental status, functional status, oxygen saturation, Neutrophil to Lymphocyte Ratio, renal function, C-Reactive Protein level, thrombocytopenia and nutritional status. The prognostic scoring system developed had a good performance.
