Caitlin Lees1, Judith Godin2, Janet E McElhaney3, Shelly A McNeil4,5, Mark Loeb6, Todd F Hatchette4,5, Jason LeBlanc5,7, William Bowie8, Guy Boivin9, Allison McGeer10, André Poirier11, Jeff Powis12, Makeda Semret13, Duncan Webster14, Melissa K Andrew2,5. 1. Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada. 2. Geriatric Medicine Research, Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada. 3. Health Sciences North Research Institute, Sudbury, Ontario, Canada. 4. Department of Medicine (Infectious Diseases), Dalhousie University, Halifax, Nova Scotia, Canada. 5. Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada. 6. Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada. 7. Department of Pathology and Laboratory Medicine, Dalhousie University, Halifax, Nova Scotia, Canada. 8. University of British Columbia, Vancouver, British Columbia, Canada. 9. Centre Hospitalier Universitaire de Québec, Quebec City, Quebec, Canada. 10. Mount Sinai Hospital, Toronto, Ontario, Canada. 11. Centre Intégré Universitaire de Santé et Services Sociaux, Quebec City, Quebec, Canada. 12. Michael Garron Hospital, Toronto, Ontario, Canada. 13. McGill University, Montreal, Quebec, Canada. 14. Saint John Hospital Regional Hospital, Dalhousie University, New Brunswick, Canada.
Abstract
BACKGROUND: We examined frailty as a predictor of recovery in older adults hospitalized with influenza and acute respiratory illness. METHODS: A total of 5011 patients aged ≥65 years were admitted to Canadian Serious Outcomes Surveillance Network hospitals during the 2011/2012, 2012/2013, and 2013/2014 influenza seasons. Frailty was measured using a previously validated frailty index (FI). Poor recovery was defined as death by 30 days postdischarge or an increase of more than 0.06 (≥2 persistent new health deficits) on the FI. Multivariable logistic regression controlled for age, sex, season, influenza diagnosis, and influenza vaccination status. RESULTS: Mean age was 79.4 (standard deviation = 8.4) years; 53.1% were women. At baseline, 15.0% (n = 750) were nonfrail, 39.3% (n = 1971) were prefrail, 39.8% (n = 1995) were frail, and 5.9% (n = 295) were most frail. Poor recovery was experienced by 21.4%, 52.0% of whom had died. Frailty was associated with lower odds of recovery in all 3 seasons: 2011/2012 (odds ratio [OR] = 0.70; 95% confidence interval [CI], 0.59-0.84), 2012/2013 (OR = 0.72; 95% CI, 0.66-0.79), and 2013/2014 (OR = 0.75; 95% CI, 0.69-0.82); results varied by season, influenza status, vaccination status, and age. CONCLUSIONS: Increasing frailty is associated with lower odds of recovery, and persistent worsening frailty is an important adverse outcome of acute illness.
BACKGROUND: We examined frailty as a predictor of recovery in older adults hospitalized with influenza and acute respiratory illness. METHODS: A total of 5011 patients aged ≥65 years were admitted to Canadian Serious Outcomes Surveillance Network hospitals during the 2011/2012, 2012/2013, and 2013/2014 influenza seasons. Frailty was measured using a previously validated frailty index (FI). Poor recovery was defined as death by 30 days postdischarge or an increase of more than 0.06 (≥2 persistent new health deficits) on the FI. Multivariable logistic regression controlled for age, sex, season, influenza diagnosis, and influenza vaccination status. RESULTS: Mean age was 79.4 (standard deviation = 8.4) years; 53.1% were women. At baseline, 15.0% (n = 750) were nonfrail, 39.3% (n = 1971) were prefrail, 39.8% (n = 1995) were frail, and 5.9% (n = 295) were most frail. Poor recovery was experienced by 21.4%, 52.0% of whom had died. Frailty was associated with lower odds of recovery in all 3 seasons: 2011/2012 (odds ratio [OR] = 0.70; 95% confidence interval [CI], 0.59-0.84), 2012/2013 (OR = 0.72; 95% CI, 0.66-0.79), and 2013/2014 (OR = 0.75; 95% CI, 0.69-0.82); results varied by season, influenza status, vaccination status, and age. CONCLUSIONS: Increasing frailty is associated with lower odds of recovery, and persistent worsening frailty is an important adverse outcome of acute illness.
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