Patients recovering from COVID-19 pneumonia in sub-acute care exhibit severe frailty: Role of the nurse assessment.
coronavirus
disability
nursing
outcome
physical function
rehabilitation
Journal
Journal of clinical nursing
ISSN: 1365-2702
Titre abrégé: J Clin Nurs
Pays: England
ID NLM: 9207302
Informations de publication
Date de publication:
Apr 2021
Apr 2021
Historique:
revised:
10
11
2020
received:
23
09
2020
accepted:
31
12
2020
pubmed:
13
1
2021
medline:
12
5
2021
entrez:
12
1
2021
Statut:
ppublish
Résumé
To document the level of frailty in sub-acute COVID-19 patients recovering from acute respiratory failure and investigate the associations between frailty, assessed by the nurse using the Blaylock Risk Assessment Screening Score (BRASS), and clinical and functional patient characteristics during hospitalisation. Frailty is a major problem in patients discharged from acute care, but no data are available on the frailty risk in survivors of COVID-19 infection. A descriptive cross-sectional study (STROBE checklist). At admission to sub-acute care in 2020, 236 COVID-19 patients (median age 77 years - interquartile range 68-83) were administered BRASS and classified into 3 levels of frailty risk. The Short Physical Performance Battery (SPPB) was also administered to measure physical function and disability. Differences between BRASS levels and associations between BRASS index and clinical parameters were analysed. The median BRASS index was 14.0 (interquartile range 9.0-20.0) denoting intermediate frailty (32.2%, 41.1%, 26.7% of patients exhibited low, intermediate and high frailty, respectively). Significant differences emerged between the BRASS frailty classes regards to sex, comorbidities, history of cognitive deficits, previous mechanical ventilation support and SPPB score. Patients with no comorbidities (14%) exhibited low frailty (BRASS: median 5.5, interquartile range 3.0-12.0). Age ≥65 years, presence of comorbidities, cognitive deficit and SPPB % predicted <50% were significant predictors of high frailty. Most COVID-19 survivors exhibit substantial frailty and require continuing care after discharge from acute care. The BRASS index is a valuable tool for nurses to identify those patients most at risk of frailty, who require a programme of rehabilitation and community reintegration.
Sections du résumé
AIMS AND OBJECTIVES
OBJECTIVE
To document the level of frailty in sub-acute COVID-19 patients recovering from acute respiratory failure and investigate the associations between frailty, assessed by the nurse using the Blaylock Risk Assessment Screening Score (BRASS), and clinical and functional patient characteristics during hospitalisation.
BACKGROUND
BACKGROUND
Frailty is a major problem in patients discharged from acute care, but no data are available on the frailty risk in survivors of COVID-19 infection.
DESIGN
METHODS
A descriptive cross-sectional study (STROBE checklist).
METHODS
METHODS
At admission to sub-acute care in 2020, 236 COVID-19 patients (median age 77 years - interquartile range 68-83) were administered BRASS and classified into 3 levels of frailty risk. The Short Physical Performance Battery (SPPB) was also administered to measure physical function and disability. Differences between BRASS levels and associations between BRASS index and clinical parameters were analysed.
RESULTS
RESULTS
The median BRASS index was 14.0 (interquartile range 9.0-20.0) denoting intermediate frailty (32.2%, 41.1%, 26.7% of patients exhibited low, intermediate and high frailty, respectively). Significant differences emerged between the BRASS frailty classes regards to sex, comorbidities, history of cognitive deficits, previous mechanical ventilation support and SPPB score. Patients with no comorbidities (14%) exhibited low frailty (BRASS: median 5.5, interquartile range 3.0-12.0). Age ≥65 years, presence of comorbidities, cognitive deficit and SPPB % predicted <50% were significant predictors of high frailty.
CONCLUSIONS
CONCLUSIONS
Most COVID-19 survivors exhibit substantial frailty and require continuing care after discharge from acute care.
RELEVANCE TO CLINICAL PRACTICE
CONCLUSIONS
The BRASS index is a valuable tool for nurses to identify those patients most at risk of frailty, who require a programme of rehabilitation and community reintegration.
Identifiants
pubmed: 33434372
doi: 10.1111/jocn.15637
pmc: PMC8014482
doi:
Types de publication
Journal Article
Langues
eng
Pagination
952-960Subventions
Organisme : 'Ricerca Corrente' funding scheme of the Italian Ministry of Health
Informations de copyright
© 2021 John Wiley & Sons Ltd.
Références
J Adv Nurs. 1999 Nov;30(5):1050-6
pubmed: 10564403
Curr Med Sci. 2020 Aug;40(4):602-607
pubmed: 32767261
Ann Am Thorac Soc. 2019 Apr;16(4):471-477
pubmed: 30571923
Thorax. 2017 Dec;72(12):1094-1103
pubmed: 28778920
Monaldi Arch Chest Dis. 2020 May 19;90(2):
pubmed: 32431134
Lancet Respir Med. 2020 Dec;8(12):1201-1208
pubmed: 32861276
BMC Geriatr. 2019 Aug 8;19(1):216
pubmed: 31395008
J Gerontol Nurs. 1992 Jul;18(7):5-10
pubmed: 1629535
Clin Infect Dis. 2020 Jul 28;71(15):740-747
pubmed: 32211844
Soc Work Health Care. 1987 Summer;12(4):61-76
pubmed: 3433191
Monaldi Arch Chest Dis. 2020 Jun 23;90(2):
pubmed: 32573175
BMC Health Serv Res. 2014 Aug 15;14:346
pubmed: 25128468
J Geriatr Phys Ther. 2021 Apr-Jun 01;44(2):94-100
pubmed: 32366793
Eur J Intern Med. 2020 Aug;78:159-160
pubmed: 32532661
Age Ageing. 2005 Sep;34(5):432-4
pubmed: 16107450
J Adv Nurs. 1997 Jun;25(6):1233-40
pubmed: 9181422
J Clin Epidemiol. 2016 Jan;69:51-60
pubmed: 26358666
Acta Biomed. 2018 Jan 16;88(4):414-425
pubmed: 29350655
Br J Nurs. 2007 Jul 26-Aug 8;16(14):882-6
pubmed: 17851351
J Gerontol. 1994 Mar;49(2):M85-94
pubmed: 8126356
Nurs Crit Care. 2002 Jul-Aug;7(4):171-5
pubmed: 12238708
Am J Respir Crit Care Med. 2016 Oct 1;194(7):831-844
pubmed: 26974173
Int J Nurs Knowl. 2014 Feb;25(1):14-21
pubmed: 24299656
J Clin Med. 2020 Jul 04;9(7):
pubmed: 32635468