What are the chances of survival of people over 70 after being treated in hospital for corona disease? Geriatricians are curious about that. They start an investigation in 15 hospitals. Because it turns out to be difficult to properly estimate the survival chances and fitness of a corona patient in advance.
People over seventy and younger people in poorer health are more vulnerable to corona disease. They become more seriously ill more often and are more at risk of death. Heavy treatment in hospital, especially in intensive care, is therefore often not recommended. Doctors start a conversation about the heavy treatments. Will it indeed lead to the desired recovery, does it still make sense? Or will such severe treatment only bring misery? A difficult estimate, which depends on how healthy or fit someone else is.
Measuring fitness
There is a lot of difference in the fitness of people over 70. One person over seventy goes on long bike rides, and the other needs help getting dressed. Doctors try to get a grip on fitness by presenting people with a standard questionnaire and calculating a score from it. This is called a ‘frailty score’ or ‘frailty index’. An example of such a questionnaire is the Groningen Frailty Indicator. The GPs also use a score list, the ‘clinical frailty scale’, when discussing possible heavy treatments in the hospital.
If the test shows that someone is not very fit, doctors expect that hospitalization or treatment in intensive care is too heavy. But is that true? A little research in England showed with preliminary results that people who were fit according to that frailty score often died from the virus. That raises questions.
Research
The geriatricians therefore want to know how good their estimates are of a person’s chances. Whether there are people with a high frailty score who have survived the disease and are now reasonably healthy again. Or the other way around: whether there are people who, according to the score, seemed quite fit, but who nevertheless surrendered a lot or who died from the virus. To do this, they will examine corona patients aged 70 and older who have been admitted to 15 hospitals. The geriatricians hope to be able to include a few thousand patients in this study.
Previous research
Professor of geriatric medicine Marcel Olde Rikkert and colleagues conducted a small study at an early stage into people over 80 who had been hospitalized with covid. He noticed that this patient group reacts differently. For example, they are less likely to have a fever or cough. More knowledge is therefore needed about the elderly patient, argued Olde Rikkert as well.
Want to read more about fitness of the over-70s? Read here: ‘Vulnerable Elder, is that me?’
Source: NRC, NTvG, elderly care platform
