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The prognostic value of the Barthel Index for mortality in patients with COVID-19: A cross-sectional study

Erchuan Wang1, Ao Liu1, Zixuan Wang1

  • 1Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.

Frontiers in Public Health
|February 10, 2023
PubMed

Insights

The Barthel Index effectively predicts mortality risk in COVID-19 patients. Lower scores indicate higher mortality, guiding tailored treatment strategies for better patient outcomes.

Area of Science:

  • Gerontology
  • Infectious Diseases
  • Clinical Medicine

Background:

  • Coronavirus disease (COVID-19) poses significant mortality risks.
  • Assessing patient prognosis is crucial for effective management.
  • Activities of Daily Living (ADL) are key indicators of patient health status.

Purpose of the Study:

  • To analyze the association between ADL, COVID-19, and the Barthel Index in predicting patient prognosis.
  • To evaluate the prognostic value of the Barthel Index for mortality in COVID-19 patients.

Main Methods:

  • Included 398 COVID-19 patients, assessing ADL with the Barthel Index upon hospital admission.
  • Analyzed the relationship between the Barthel Index and patient mortality risk.
  • Utilized regression models and a decision tree to assess prognostic value.

Main Results:

  • Deceased patients had significantly lower Barthel Index scores (median 65) compared to discharged patients (median 90).
  • A decrease in Barthel Index scores correlated with increased mortality risk (P < 0.001).
  • The Barthel Index independently predicted prognosis (OR = 0.809) even after adjusting for clinical factors. Patients with scores <70 had higher mortality (33.3-40.0%), while scores >90 indicated better outcomes (2.7-7.2% mortality).

Conclusions:

  • The Barthel Index holds significant prognostic value for COVID-19 patient mortality.
  • COVID-19 patients can be stratified into emergency (0-70), observation (70-90), and normal (90-100) groups based on Barthel Index scores.
  • This stratification allows for the implementation of distinct and appropriate treatment strategies.
Abstract

Keywords:
Barthel IndexCOVID-19activities of daily livingdecision treeprognosis

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