{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T01:18:24Z","timestamp":1747185504922,"version":"3.40.5"},"reference-count":27,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2022,9,6]],"date-time":"2022-09-06T00:00:00Z","timestamp":1662422400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004752","name":"State Government of Victoria","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004752","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Internal Medicine Journal"],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Residential InReach presents an alternative to hospital admission for aged care residents swabbed for coronavirus disease 2019 (COVID\u201019), although relative outcomes remain unknown.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To compare rates and predictors of 28\u2010day mortality for aged care residents seen by InReach with COVID\u201019, or \u2018suspected COVID\u201019\u2019 (sCOVID), including hospital versus InReach\u2010based care.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Prospective observational study of consecutive patients referred to a Victorian InReach service meeting COVID\u201019 testing criteria between April and October 2020 (prevaccine availability). COVID\u201019 was determined by positive polymerase chain reaction testing on nasopharyngeal swab. sCOVID\u201019 was defined as meeting symptomatic Victorian Government testing criteria but persistently swab negative.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were no significant differences in age, sex, Clinical Frailty Score (CFS) or Charlson Comorbidity Index (CCI) between 152 patients with COVID\u201019 and 118 patients with sCOVID. Similar results were found for 28\u2010day mortality between patients with COVID\u201019 (35\/152, 23%) and sCOVID (32\/118, 27%) (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.4). For the combined cohort, 28\u2010day mortality was associated with initial oxygen saturation (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001), delirium (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001), hospital transfer for acuity (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.02; but not public health\/facility reasons), CFS (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.04), prior ischaemic heart disease (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.01) and dementia (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.02). For patients with COVID\u201019, 28\u2010day mortality was associated with initial oxygen saturation (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.02), delirium (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) and hospital transfer for acuity (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.01), but not public health\/facility reasons.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Unvaccinated aged care residents meeting COVID\u201019 testing criteria seen by InReach during a pandemic experience high mortality rates, including with negative swab result. Residents remaining within\u2010facility (with InReach) experienced similar adjusted mortality odds to residents transferred to hospital for public health\/facility\u2010based reasons, and lower than those transferred for clinical acuity.<\/jats:p><\/jats:sec>","DOI":"10.1111\/imj.15914","type":"journal-article","created":{"date-parts":[[2022,8,26]],"date-time":"2022-08-26T02:19:16Z","timestamp":1661480356000},"page":"690-699","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Site of care and factors associated with mortality in unvaccinated Australian aged care residents during COVID\u201019 outbreaks"],"prefix":"10.1111","volume":"53","author":[{"given":"Nicholas J.","family":"Radcliffe","sequence":"first","affiliation":[{"name":"Department of Geriatric Medicine Austin Health  Melbourne Victoria 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