External Validation of Mortality Scores among High-Risk COVID-19 Patients: A Romanian Retrospective Study in the First Pandemic Year

Background: We aimed to externally validate three prognostic scores for COVID-19: the 4C Mortality Score (4CM Score), the COVID-GRAM Critical Illness Risk Score (COVID-GRAM), and COVIDAnalytics. Methods: We evaluated the scores in a retrospective study on adult patients hospitalized with severe/crit...

Full description

Saved in:
Bibliographic Details
Published in:Journal of clinical medicine 2022-09, Vol.11 (19), p.5630
Main Authors: Rădulescu, Amanda, Lupse, Mihaela, Istrate, Alexandru, Calin, Mihai, Topan, Adriana, Kormos, Nicholas Florin, Macicasan, Raul Vlad, Briciu, Violeta
Format: Article
Language:English
Subjects:
Accuracy
Age
Asymptomatic
Clinical medicine
Comorbidity
Coronaviruses
COVID-19
Disease
Fatalities
Generalized linear models
Hospitals
Laboratories
Medical prognosis
Mortality
Oxygen saturation
Pandemics
Patients
Severe acute respiratory syndrome coronavirus 2
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Background: We aimed to externally validate three prognostic scores for COVID-19: the 4C Mortality Score (4CM Score), the COVID-GRAM Critical Illness Risk Score (COVID-GRAM), and COVIDAnalytics. Methods: We evaluated the scores in a retrospective study on adult patients hospitalized with severe/critical COVID-19 (1 March 2020–1 March 2021), in the Teaching Hospital of Infectious Diseases, Cluj-Napoca, Romania. We assessed all the deceased patients matched with two survivors by age, gender, and at least two comorbidities. The areas under the receiver-operating characteristic curves (AUROCs) were computed for in-hospital mortality. Results: Among 780 severe/critical COVID-19 patients, 178 (22.8%) died. We included 474 patients according to the case definition (158 deceased/316 survivors). The median age was 75 years; diabetes mellitus, malignancies, chronic pulmonary diseases, and chronic kidney and moderate/severe liver diseases were associated with higher risks of death. According to the predefined 4CM Score, the mortality rates were 0% (low), 13% (intermediate), 27% (high), and 61% (very high). The AUROC for the 4CM Score was 0.72 (95% CI: 0.67–0.77) for in-hospital mortality, close to COVID-GRAM, with slightly greater discriminatory ability for COVIDAnalytics: 0.76 (95% CI: 0.71–0.80). Conclusion: All the prognostic scores showed close values compared to their validation cohorts, were fairly accurate in predicting mortality, and can be used to prioritize care and resources.
ISSN:2077-0383
2077-0383
DOI:10.3390/jcm11195630