Modulation of the Association Between Age and Death by Risk Factor Burden in Critically Ill Patients With COVID-19. (29th August 2022)

• Record Type: Journal Article
• Authors: Sunderraj, Ashwin; Cho, Chloe; Cai, Xuan; Gupta, Shruti; Mehta, Rupal; Isakova, Tamara; Leaf, David E.; Srivastava, Anand
• Other Names: Walther Carl P. author non-byline.; Anumudu Samaya J. author non-byline.; Arunthamakun Justin author non-byline.; Kopecky Kathleen F. author non-byline.; Milligan Gregory P. author non-byline.; McCullough Peter A. author non-byline.; Nguyen Thuy-Duyen author non-byline.; Shaefi Shahzad author non-byline.; Krajewski Megan L. author non-byline.; Shankar Sidharth author non-byline.; Pannu Ameeka author non-byline.; Valencia Juan D. author non-byline.; Waikar Sushrut S. author non-byline.; Kibbelaar Zoe A. author non-byline.; Athavale Ambarish M. author non-byline.; Hart Peter author non-byline.; Upadhyay Shristi author non-byline.; Vohra Ishaan author non-byline.; Oyintayo Ajiboye author non-byline.; Green Adam author non-byline.; Rachoin Jean-Sebastien author non-byline.; Schorr Christa A. author non-byline.; Shea Lisa author non-byline.; Edmonston Daniel L. author non-byline.; Mosher Christopher L. author non-byline.; Shehata Alexandre M. author non-byline.; Cohen Zaza author non-byline.; Allusson Valerie author non-byline.; Bambrick-Santoyo Gabriela author non-byline.; Bhatti Noor ul aain author non-byline.; Mehta Bijal author non-byline.; Williams Aquino author non-byline.; Brenner Samantha K. author non-byline.; Walters Patricia author non-byline.; Go Ronaldo C. author non-byline.; Rose Keith M. author non-byline.; Hernán Miguel A. author non-byline.; Zhou Amy M. author non-byline.; Kim Ethan C. author non-byline.; Lisk Rebecca author non-byline.; Chan Lili author non-byline.; Mathews Kusum S. author non-byline.; Coca Steven G. author non-byline.; Altman Deena R. author non-byline.; Saha Aparna author non-byline.; Soh Howard author non-byline.; Hsun Wen Huei author non-byline.; Bose Sonali author non-byline.; Leven Emily A. author non-byline.; Wang Jing G. author non-byline.; Mosoyan Gohar author non-byline.; Nadkarni Girish N. author non-byline.; Pattharanitima Pattharawin author non-byline.; Gallagher Emily J. author non-byline.; Friedman Allon N. author non-byline.; 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Guru Pramod K. author non-byline.; Kashani Kianoush author non-byline.; Tehranian Shahrzad author non-byline.; Zhou Yan author non-byline.; Bergl Paul A. author non-byline.; Rodriguez Jesus author non-byline.; Shah Jatan A. author non-byline.; Gupta Mrigank S. author non-byline.; Kumar Princy N. author non-byline.; Lazarous Deepa G. author non-byline.; Kassaye Seble G. author non-byline.; Melamed Michal L. author non-byline.; Johns Tanya S. author non-byline.; Mocerino Ryan author non-byline.; Prudhvi Kalyan author non-byline.; Zhu Denzel author non-byline.; Levy Rebecca V. author non-byline.; Azzi Yorg author non-byline.; Fisher Molly author non-byline.; Yunes Milagros author non-byline.; Sedaliu Kaltrina author non-byline.; Golestaneh Ladan author non-byline.; Brogan Maureen author non-byline.; Kumar Neelja author non-byline.; Chang Michael author non-byline.; Thakkar Jyotsana author non-byline.; Raichoudhury Ritesh author non-byline.; Athreya Akshay author non-byline.; Farag Mohamed author non-byline.; Schenck Edward J. author non-byline.; Cho Soo Jung author non-byline.; Plataki Maria author non-byline.; Alvarez-Mulett Sergio L. author non-byline.; Gomez-Escobar Luis G. author non-byline.; Pan Di author non-byline.; Lee Stefi author non-byline.; Krishnan Jamuna author non-byline.; Whalen William author non-byline.; Charytan David author non-byline.; Macina Ashley author non-byline.; Chaudhry Sobaata author non-byline.; Wu Benjamin author non-byline.; Modersitzki Frank author non-byline.; Srivastava Anand author non-byline.; Leidner Alexander S. author non-byline.; Martinez Carlos author non-byline.; Kruser Jacqueline M. author non-byline.; Wunderink Richard G. author non-byline.; Hodakowski Alexander J. author non-byline.; Velez Juan Carlos Q. author non-byline.; Price-Haywood Eboni G. author non-byline.; Matute-Trochez Luis A. author non-byline.; Hasty Anna E. author non-byline.; Mohamed Muner MB. author non-byline.; Avasare Rupali S. author non-byline.; Zonies David author non-byline.; Leaf David E. author non-byline.; Gupta Shruti author non-byline.; Sise Meghan E. author non-byline.; Newman Erik T. author non-byline.; Abu Omar Samah author non-byline.; Pokharel Kapil K. author non-byline.; Sharma Shreyak author non-byline.; Singh Harkarandeep author non-byline.; Correa Simon author non-byline.; Shaukat Tanveer author non-byline.; Kamal Omer author non-byline.; Wang Wei author non-byline.; Yang Heather author non-byline.; Boateng Jeffery O. author non-byline.; Lee Meghan author non-byline.; Strohbehn Ian A. author non-byline.; Li Jiahua author non-byline.; Mueller Ariel L. author non-byline.; Redfern Roberta E. author non-byline.; Cairl Nicholas S. author non-byline.; Naimy Gabriel author non-byline.; Abu-Saif Abeer author non-byline.; Hall Danyell author non-byline.; Bickley Laura author non-byline.; Rowan Chris author non-byline.; Madhani-Lovely Farah author non-byline.; Cruz Vivian S. author non-byline.; Hess Kristen M. author non-byline.; Jacobs Alanna L. author non-byline.; Peev Vasil author non-byline.; Reiser Jochen author non-byline.; Byun John J. author non-byline.; Vissing Andrew author non-byline.; Kapania Esha M. author non-byline.; Post Zoe author non-byline.; Patel Nilam P. author non-byline.; Hermes Joy-Marie author non-byline.; Sutherland Anne K. author non-byline.; Patrawalla Amee author non-byline.; Finkel Diana G. author non-byline.; Danek Barbara A. author non-byline.; Arikapudi Sowminya author non-byline.; Paer Jeffrey M. author non-byline.; Cangialosi Peter author non-byline.; Liotta Mark author non-byline.; Radbel Jared author non-byline.; Puri Sonika author non-byline.; Sunderram Jag author non-byline.; Scharf Matthew T. author non-byline.; Ahmed Ayesha author non-byline.; Berim Ilya author non-byline.; Vatson Jayanth S. author non-byline.; Anand Shuchi author non-byline.; Levitt Joseph E. author non-byline.; Garcia Pablo author non-byline.; Boyle Suzanne M. author non-byline.; Song Rui author non-byline.; Zhang Jingjing author non-byline.; Hoon Woo Sang author non-byline.; Deng Xiaoying author non-byline.; Katz-Greenberg Goni author non-byline.; Senter Katharine author non-byline.; Sharshir Moh'd A. author non-byline.; Rusnak Vadym V. author non-byline.; Ali Muhammad Imran author non-byline.; Bansal Anip author non-byline.; Podoll Amber S. author non-byline.; Chonchol Michel author non-byline.; Sharma Sunita author non-byline.; Burnham Ellen L. author non-byline.; Douin David J. author non-byline.; Rashidi Arash author non-byline.; Hejal Rana author non-byline.; Judd Eric author non-byline.; Latta Laura author non-byline.; Tolwani Ashita author non-byline.; Albertson Timothy E. author non-byline.; Adams Jason Y. author non-byline.; Chang Steven Y. author non-byline.; Beutler Rebecca M. author non-byline.; Schulze Carl E. author non-byline.; Macedo Etienne author non-byline.; Rhee Harin author non-byline.; Liu Kathleen D. author non-byline.; Jotwani Vasantha K. author non-byline.; Koyner Jay L. author non-byline.; Shah Chintan V. author non-byline.; 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• Is Part Of: Critical care explorations. Volume 4:Number 9(2022)
• Page Start: e0755
• Publication Date: 2022-08-29
• Subjects: age -- COVID-19 -- critical care -- death -- risk factors
• DOI: 10.1097/CCE.0000000000000755
• Languages: English
• ISSNs: 2639-8028

Abstract

Abstract : OBJECTIVES: Older age is a key risk factor for adverse outcomes in critically ill patients with COVID-19. However, few studies have investigated whether preexisting comorbidities and acute physiologic ICU factors modify the association between age and death. DESIGN: Multicenter cohort study. SETTING: ICUs at 68 hospitals across the United States. PATIENTS: A total of 5, 037 critically ill adults with COVID-19 admitted to ICUs between March 1, 2020, and July 1, 2020. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: The primary exposure was age, modeled as a continuous variable. The primary outcome was 28-day inhospital mortality. Multivariable logistic regression tested the association between age and death. Effect modification by the number of risk factors was assessed through a multiplicative interaction term in the logistic regression model. Among the 5, 037 patients included (mean age, 60.9 yr [± 14.7], 3, 179 [63.1%] male), 1, 786 (35.4%) died within 28 days. Age had a nonlinear association with 28-day mortality ( p for nonlinearity <0.001) after adjustment for covariates that included demographics, preexisting comorbidities, acute physiologic ICU factors, number of ICU beds, and treatments for COVID-19. The number of preexisting comorbidities and acute physiologic ICU factors modified the association between age and 28-day mortality ( p for interaction <0.001), but this effect modification was modest as age still had an exponential relationship with death in subgroups stratified by the number of risk factors. CONCLUSIONS: In a large population of critically ill patients with COVID-19, age had an independent exponential association with death. The number of preexisting comorbidities and acute physiologic ICU factors modified the association between age and death, but age still had an exponential association with death in subgroups according to the number of risk factors present. Additional studies are needed to identify the mechanisms underpinning why older age confers an increased risk of death in critically ill patients with COVID-19.