Evidence map›Paper›PMID 35776284›Full record

ArticleAging clinical and experimental research2022

Relationship of frailty with excess mortality during the COVID-19 pandemic: a population-level study in Ontario, Canada.

Harindra C Wijeysundera, Husam Abdel-Qadir, Feng Qiu, Ragavie Manoragavan, Peter C Austin, Moira K Kapral, Jeffrey C Kwong, Louise Y Sun, Heather J Ross, Jacob A Udell and 5 more

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Aging clinical and experimental research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
0.8field-weighted citation impact, top 32% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 6 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 5 institutions in 1 country.

Harindra C WijeysunderaInstitute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada. harindra.wijeysundera@sunnybrook.ca.
Husam Abdel-QadirInstitute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada.
Feng QiuICES, Toronto, Canada.
Ragavie ManoragavanSchulich Heart Program, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Ave., Room A202, Toronto, ON, M4N 3M5, Canada.
Peter C AustinInstitute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada.
Moira K KapralInstitute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada.
Jeffrey C KwongICES, Toronto, Canada.
Louise Y SunICES, Toronto, Canada.
Heather J RossTemerty Faculty of Medicine, University of Toronto, Toronto, Canada.
Jacob A UdellInstitute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada.
Idan RoifmanInstitute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada.
Amy Y X YuInstitute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada.
Anna ChuICES, Toronto, Canada.
Finlay A McAlisterDivision of General Internal Medicine, University of Alberta, Edmonton, Canada.
Douglas S LeeInstitute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada.
Institute for Clinical Evaluative Sciences · CAUniversity of Toronto · CAHealth Sciences Centre · CAUniversity of Alberta · CAUniversity of Ottawa · CA

Funding

Canadian Frailty Network CFN-006Canadian institute for health research VR4 172736
6 · The paper itself

Abstract

backgroundThere is a paucity of the literature on the relationship between frailty and excess mortality due to the COVID-19 pandemic.

methodsThe entire community-dwelling adult population of Ontario, Canada, as of January 1st, 2018, was identified using the Cardiovascular Health in Ambulatory Care Research Team (CANHEART) cohort. Residents of long-term care facilities were excluded. Frailty was categorized through the Johns Hopkins Adjusted Clinical Groups (ACG® System) frailty indicator. Follow-up was until December 31st, 2020, with March 11th, 2020, indicating the beginning of the COVID-19 pandemic. Using multivariable Cox models with patient age as the timescale, we determined the relationship between frailty status and pandemic period on all-cause mortality. We evaluated the modifier effect of frailty using both stratified models as well as incorporating an interaction between frailty and the pandemic period.

resultsWe identified 11,481,391 persons in our cohort, of whom 3.2% were frail based on the ACG indicator. Crude mortality increased from 0.75 to 0.87% per 100 person years from the pre- to post-pandemic period, translating to ~ 13,800 excess deaths among the community-dwelling adult population of Ontario (HR 1.11 95% CI 1.09-1.11). Frailty was associated with a statistically significant increase in all-cause mortality (HR 3.02, 95% CI 2.99-3.06). However, all-cause mortality increased similarly during the pandemic in frail (aHR 1.13, 95% CI 1.09-1.16) and non-frail (aHR 1.15, 95% CI 1.13-1.17) persons.

conclusionAlthough frailty was associated with greater mortality, frailty did not modify the excess mortality associated with the pandemic.

Indexed as

COVID-19FrailtyAgedFrail ElderlyHumansOntarioPandemicsCOVID-19Excess mortalityFrailtyPopulation-based study

Identifiers

PMID35776284
PMCPMC9638449
OpenAlexW4283743389

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.