Mortality among hospitalized nursing home residents with COVID-19

Kohl, Raphael; Schwinger, Antje; Jürchott, Kathrin; Hering, Christian; Gangnus, Annabell; Steinhagen‐Thiessen, Elisabeth; Kuhlmey, Adelheid; Gellert, Paul

doi:10.3238/arztebl.m2022.0140

Cited by 7 publications

(5 citation statements)

References 2 publications

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“…Studies were excluded if members of the study population were transferred to acute hospitals due to variations in care levels, staffing, and in the environment [15]. Inclusion of hospital transfers might introduce a potential sampling bias, for example, a study of hospitalized residents diagnosed with COVID-19 exhibited a significantly elevated mortality rate (ranging from 51.6% to 59.3%), contrasting with control samples (8.1% to 9.7%) within LTCFs [16]. Additional grounds for exclusion were met when the study's participants resided in alternative types of facilities, such as retirement homes, where residents had limited medical and daily assistance needs, or when the studies were oriented towards assessing the effects of interventions on outcomes related to COVID-19.…”

Section: Eligibility Criteriamentioning

confidence: 99%

Drivers of COVID-19 Outcomes in Long-Term Care Facilities Using Multi-Level Analysis: A Systematic Review

Karimi-Dehkordi,

Hanson,

Silvius

et al. 2024

Healthcare

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This study aimed to identify the individual, organizational, and environmental factors which contributed to COVID-19-related outcomes in long-term care facilities (LTCFs). A systematic review was conducted to summarize and synthesize empirical studies using a multi-level analysis approach to address the identified influential factors. Five databases were searched on 23 May 2023. To be included in the review, studies had to be published in peer-reviewed journals or as grey literature containing relevant statistical data. The Joanna Briggs Institute critical appraisal tool was employed to assess the methodological quality of each article included in this study. Of 2137 citations identified after exclusions, 99 records met the inclusion criteria. The predominant individual, organizational, and environmental factors that were most frequently found associated with the COVID-19 outbreak comprised older age, higher dependency level; lower staffing levels and lower star and subset domain ratings for the facility; and occupancy metrics and co-occurrences of outbreaks in counties and communities where the LTCFs were located, respectively. The primary individual, organizational, and environmental factors frequently linked to COVID-19-related deaths comprised age, and male sex; higher percentages of racial and ethnic minorities in LTCFs, as well as ownership types (including private, for-profit, and chain membership); and higher occupancy metrics and LTCF’s size and bed capacity, respectively. Unfolding the risk factors collectively may mitigate the risk of outbreaks and pandemic-related mortality in LTCFs during future endemic and pandemics through developing and improving interventions that address those significant factors.

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Section: Eligibility Criteriamentioning

confidence: 99%

Drivers of COVID-19 Outcomes in Long-Term Care Facilities Using Multi-Level Analysis: A Systematic Review

Karimi-Dehkordi,

Hanson,

Silvius

et al. 2024

Healthcare

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“…Seit Beginn der COVID-19-Pandemie im März 2020 waren die Einrichtungen der vollstationären Langzeitpflege schwer von deren Folgen betroffen. Eine erhöhte Sterblichkeit und eingeschränkte soziale Teilhabe der Bewohnenden als auch eine erhöhte Arbeitsbelastung der Pflegekräfte konnten beobachtet werden [ 4 , 6 , 8 , 12 ]. Daher startete die COVID-19-Impfkampagne priorisiert in den Alten- und Pflegeheimen Deutschlands.…”

Section: Hintergrundunclassified

COVID-19 vaccination status among nurses and associated factors in long-term care facilities

et al. 2023

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Zusammenfassung Hintergrund Das Pflegepersonal in der vollstationären Langzeitpflege wurde prioritär geimpft, um die Infektionsgefahr für Bewohnende zu reduzieren und die Arbeitsfähigkeit zu erhalten. Zwar wurde die Impfquote des Pflegepersonals durch eine einrichtungsbezogene Impfpflicht erhöht, Untersuchungen zu assoziierten Faktoren des Impfstatus liegen für Deutschland jedoch nicht vor. Ziel Identifikation von assoziierten Faktoren des COVID-19-Impfstatus von Pflegepersonal in der vollstationären Langzeitpflege. Methoden Im Zeitraum vom 26.10.2021 bis 31.01.2022 antworteten insgesamt N = 1546 Pflegekräfte auf eine Online-Befragung im Rahmen des Projekts Covid-Heim, welche u. a. die Impfkampagne fokussierte und mittels logistischer Regressionsanalysen ausgewertet wurde. Ergebnisse Acht von 10 Pflegekräften gaben an, gegen COVID-19 geimpft zu sein (80,6 %). Etwa 7 von 10 Pflegekräften dachten seit Beginn der Pandemie mindestens einige Male daran, ihren Beruf aufzugeben (71,4 %). Ein positiver COVID-19-Impfstatus war assoziiert mit höherem Alter, einer Vollzeitbeschäftigung, COVID-19-Todesfällen in der Einrichtung, einem Tätigkeitsort in Nord- oder Westdeutschland. Häufige Gedanken an eine Aufgabe des Berufs waren mit einem negativen COVID-19-Impfstatus assoziiert. Diskussion Die vorliegenden Befunde geben erstmalig Hinweise auf Faktoren, die mit dem COVID-19-Impfstatus von Pflegepersonal in der stationären Langzeitpflege in Deutschland zusammenhängen. Weiterführende quantitative wie qualitative Untersuchungen sind notwendig für ein tieferes Verständnis der Entscheidung für oder gegen eine COVID-19-Impfung bei Pflegenden in der stationären Langzeitpflege, um künftige Impfkampagnen in diesem Bereich zielgerichteter umsetzen zu können.

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“…Healthcare utilization during the pandemic including in-hospital care decreased massively in most countries around the globe (e.g., 1 – 6 ). Rates of emergency hospital admissions due to acute events dropped in the general population, including cardiovascular diseases (CVD) such as myocardial infarction (MI) and stroke (e.g., 7 – 10 ).…”

Section: Introductionmentioning

confidence: 99%

“…Residents of long-term care facilities (LTCF) not only faced high mortality and hospitalization rates due to COVID-19 1 ; they may further be subject of greatly decreased hospitalization rates for CVD compared with rates prior to the pandemic. There is evidence from Ontario, Canada that this was true for older adults including community-dwelling older adults with dementia 13 , but evidence for LTCF residents is rare.…”

Section: Introductionmentioning

confidence: 99%

Hospital admissions and deaths due to acute cardiovascular events during the COVID-19 pandemic in residents of long-term care facilities

Gellert

Kohl

Jürchott

et al. 2023

Sci Rep

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Hospital admissions due to acute cardiovascular events dropped during the COVID-19 pandemic in the general population; however, evidence for residents of long-term care facilities (LTCF) is sparse. We investigated rates of hospital admissions and deaths due to myocardial infarction (MI) and stroke in LTCF residents during the pandemic. Our nationwide cohort study used claims data. The sample comprised 1,140,139 AOK-ensured LTCF residents over 60 years of age (68.6% women; age 85.3 ± 8.5 years) from the largest statutory health insurance in Germany (AOK), which is not representative for all LTCF residents. We included MI and stroke admission and compared numbers of in-hospital deaths from January 2020 to end of April 2021 (i.e., during the first three waves of the pandemic) with the number of incidences in 2015–2019. To estimate incidence risk ratios (IRR), adjusted Poisson regression analyses were applied. During the observation period (2015–2021), there were 19,196 MI and 73,953 stroke admissions. MI admissions declined in the pandemic phase by 22.5% (IRR = 0.68 [CI 0.65–0.72]) compared to previous years. This decline was slightly more pronounced for NSTEMI than for STEMI. MI fatality risks remained comparable across years (IRR = 0.97 [CI95% 0.92–1.02]). Stroke admissions dropped by 15.1% (IRR = 0.75 [CI95% 0.72–0.78]) in the pandemic. There was an elevated case fatality risk for haemorrhagic stroke (IRR = 1.09 [CI95% 1.03–1.15]) but not for other stroke subtypes compared to previous years. This study provides first evidence of declines in MI and stroke admissions and in-hospital deaths among LTCF residents during the pandemic. The figures are alarming given the acute nature of the conditions and the vulnerability of the residents.

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Mortality among hospitalized nursing home residents with COVID-19

Cited by 7 publications

References 2 publications

Drivers of COVID-19 Outcomes in Long-Term Care Facilities Using Multi-Level Analysis: A Systematic Review

Drivers of COVID-19 Outcomes in Long-Term Care Facilities Using Multi-Level Analysis: A Systematic Review

COVID-19 vaccination status among nurses and associated factors in long-term care facilities

Hospital admissions and deaths due to acute cardiovascular events during the COVID-19 pandemic in residents of long-term care facilities

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