Predicting In-Hospital Mortality in COVID-19 Older Patients with Specifically Developed Scores

Marcello Covino, Antonio Gasbarrini, Francesco Franceschi, Claudio Sandroni, Giuseppe De Matteis, Andrea Russo, Elia Forte, Andrea Piccioni, Benedetta Simeoni

Risultato della ricerca: Contributo in rivistaArticolo in rivista

3 Citazioni (Scopus)

Abstract

Background/Objectives Several scoring systems have been specifically developed for risk stratification in COVID-19 patients.Design We compared, in a cohort of confirmed COVID-19 older patients, three specifically developed scores with a previously established early warning score. Main endpoint was all causes in-hospital death.Setting This is a single-center, retrospective observational study, conducted in the Emergency Department (ED) of an urban teaching hospital, referral center for COVID-19.Participants We reviewed the clinical records of the confirmed COVID-19 patients aged 60 years or more consecutively admitted to our ED over a 6-week period (March 1st to April 15th, 2020). A total of 210 patients, aged between 60 and 98 years were included in the study cohort.Measurements International Severe Acute Respiratory Infection Consortium Clinical Characterization Protocol-Coronavirus Clinical Characterization Consortium (ISARIC-4C) score, COVID-GRAM Critical Illness Risk Score (COVID-GRAM), quick COVID-19 Severity Index (qCSI), National Early Warning Score (NEWS).Results Median age was 74 (67-82) and 133 (63.3%) were males. Globally, 42 patients (20.0%) deceased. All the score evaluated showed a fairly good predictive value with respect to in-hospital death. The ISARIC-4C score had the highest area under ROC curve (AUROC) 0.799 (0.738-0.851), followed by the COVID-GRAM 0.785 (0.723-0.838), NEWS 0.764 (0.700-0.819), and qCSI 0.749 (0.685-0.806). However, these differences were not statistical significant.Conclusion Among the evaluated scores, the ISARIC-4C and the COVID-GRAM, calculated at ED admission, had the best performance, although the qCSI had similar efficacy by evaluating only three items. However, the NEWS, already widely validated in clinical practice, had a similar performance and could be appropriate for older patients with COVID-19.
Lingua originaleEnglish
pagine (da-a)37-43
Numero di pagine7
RivistaJournal of the American Geriatrics Society
Volume69
DOI
Stato di pubblicazionePubblicato - 2021

Keywords

  • 4C
  • COVID‐19
  • GRAM
  • ISARIC‐
  • NEWS
  • qCSI

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