Treatment intensity and mortality among COVID‐19 patients with dementia: A retrospective observational study

Background We sought to determine whether dementia is associated with treatment intensity and mortality in patients hospitalized with COVID‐19. Methods This study includes review of the medical records for patients >60 years of age (n = 5394) hospitalized with COVID‐19 from 132 community hospital...

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Bibliographic Details
Published in:Journal of the American Geriatrics Society (JAGS) 2022-01, Vol.70 (1), p.40-48
Main Authors: Barnato, Amber E., Birkmeyer, John D., Skinner, Jonathan S., O'Malley, A. James, Birkmeyer, Nancy J. O.
Format: Article
Language:English
Subjects:
advance care planning
Advance Care Planning - statistics & numerical data
Advance directives
Aged
Aged, 80 and over
Comorbidity
COVID-19
COVID-19 - mortality
COVID-19 - therapy
Dementia
Dementia - complications
Dementia - mortality
Dementia disorders
Female
Hospital Mortality - trends
Hospitalization
Hospitals
Humans
intensive care
Intensive Care Units - statistics & numerical data
Male
Mechanical ventilation
Medical records
Mortality
Observational studies
Patients
Respiration, Artificial - statistics & numerical data
Resuscitation Orders
Retrospective Studies
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Summary:Background We sought to determine whether dementia is associated with treatment intensity and mortality in patients hospitalized with COVID‐19. Methods This study includes review of the medical records for patients >60 years of age (n = 5394) hospitalized with COVID‐19 from 132 community hospitals between March and June 2020. We examined the relationships between dementia and treatment intensity (including intensive care unit [ICU] admission and mechanical ventilation [MV] and care processes that may influence them, including advance care planning [ACP] billing and do‐not‐resuscitate [DNR] orders) and in‐hospital mortality adjusting for age, sex, race/ethnicity, comorbidity, month of hospitalization, and clustering within hospital. We further explored the effect of ACP conversations on the relationship between dementia and outcomes, both at the individual patient level (effect of having ACP) and at the hospital level (effect of being treated at a hospital with low: 20% ACP rates). Results Ten percent (n = 522) of the patients had documented dementia. Dementia patients were older (>80 years: 60% vs. 27%, p 
ISSN:0002-8614
1532-5415
DOI:10.1111/jgs.17463