The impact of COVID-19 on adjusted mortality risk in care homes for older adults in Wales, UK: a retrospective population-based cohort study for mortality in 2016-2020.
Aged
COVID-19
/ mortality
COVID-19 Testing
/ methods
Female
Health Status Disparities
Homes for the Aged
/ statistics & numerical data
Humans
Infection Control
/ methods
Male
Mortality
Needs Assessment
Nursing Homes
/ statistics & numerical data
Personal Protective Equipment
/ supply & distribution
Risk Assessment
SARS-CoV-2
/ isolation & purification
Wales
/ epidemiology
Workload
/ standards
COVID-19
care homes
frailty
mortality
older people
Journal
Age and ageing
ISSN: 1468-2834
Titre abrégé: Age Ageing
Pays: England
ID NLM: 0375655
Informations de publication
Date de publication:
08 01 2021
08 01 2021
Historique:
received:
03
07
2020
pubmed:
21
9
2020
medline:
20
1
2021
entrez:
20
9
2020
Statut:
ppublish
Résumé
mortality in care homes has had a prominent focus during the COVID-19 outbreak. Care homes are particularly vulnerable to the spread of infectious diseases, which may lead to increased mortality risk. Multiple and interconnected challenges face the care home sector in the prevention and management of outbreaks of COVID-19, including adequate supply of personal protective equipment, staff shortages and insufficient or lack of timely COVID-19 testing. to analyse the mortality of older care home residents in Wales during COVID-19 lockdown and compare this across the population of Wales and the previous 4 years. we used anonymised electronic health records and administrative data from the secure anonymised information linkage databank to create a cross-sectional cohort study. We anonymously linked data for Welsh residents to mortality data up to the 14th June 2020. we calculated survival curves and adjusted Cox proportional hazards models to estimate hazard ratios (HRs) for the risk of mortality. We adjusted HRs for age, gender, social economic status and prior health conditions. survival curves show an increased proportion of deaths between 23rd March and 14th June 2020 in care homes for older people, with an adjusted HR of 1.72 (1.55, 1.90) compared with 2016. Compared with the general population in 2016-2019, adjusted care home mortality HRs for older adults rose from 2.15 (2.11, 2.20) in 2016-2019 to 2.94 (2.81, 3.08) in 2020. the survival curves and increased HRs show a significantly increased risk of death in the 2020 study periods.
Sections du résumé
BACKGROUND
mortality in care homes has had a prominent focus during the COVID-19 outbreak. Care homes are particularly vulnerable to the spread of infectious diseases, which may lead to increased mortality risk. Multiple and interconnected challenges face the care home sector in the prevention and management of outbreaks of COVID-19, including adequate supply of personal protective equipment, staff shortages and insufficient or lack of timely COVID-19 testing.
AIM
to analyse the mortality of older care home residents in Wales during COVID-19 lockdown and compare this across the population of Wales and the previous 4 years.
STUDY DESIGN AND SETTING
we used anonymised electronic health records and administrative data from the secure anonymised information linkage databank to create a cross-sectional cohort study. We anonymously linked data for Welsh residents to mortality data up to the 14th June 2020.
METHODS
we calculated survival curves and adjusted Cox proportional hazards models to estimate hazard ratios (HRs) for the risk of mortality. We adjusted HRs for age, gender, social economic status and prior health conditions.
RESULTS
survival curves show an increased proportion of deaths between 23rd March and 14th June 2020 in care homes for older people, with an adjusted HR of 1.72 (1.55, 1.90) compared with 2016. Compared with the general population in 2016-2019, adjusted care home mortality HRs for older adults rose from 2.15 (2.11, 2.20) in 2016-2019 to 2.94 (2.81, 3.08) in 2020.
CONCLUSIONS
the survival curves and increased HRs show a significantly increased risk of death in the 2020 study periods.
Identifiants
pubmed: 32951042
pii: 5908996
doi: 10.1093/ageing/afaa207
pmc: PMC7546151
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
25-31Subventions
Organisme : HCRW_
ID : HCRW_HRG-16-1325
Pays : United Kingdom
Organisme : HCRW_
ID : HCRW_SCF-18-1504
Pays : United Kingdom
Organisme : Medical Research Council
ID : MC_PC_20029
Pays : United Kingdom
Informations de copyright
© The Author(s) 2020. Published by Oxford University Press on behalf of the British Geriatrics Society.
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