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Predicting mortality in COVID-19: Comparison of apache iv, mews, and MSOFA
Critical Care Medicine ; 49(1 SUPPL 1):102, 2021.
Article in English | EMBASE | ID: covidwho-1193921
ABSTRACT

INTRODUCTION:

The novel coronavirus disease (COVID-19), is an infectious disease caused by the newly discovered virus (SARS-CoV-2). A few COVID-19 patients can have severe disease that is life-threatening and require ICU admission. The objective of this study is to compare the performance of APACHE IV (Acute Physiology and Chronic Health Evaluation), MEWS (Modified Early Warning Score), and mSOFA (Modified Sequential Organ Failure Assessment) in predicting mortality in COVID-19 patients admitted to the ICU.

METHODS:

All data ware retrospectively collected from electronic health records of COVID-19 patients on day 1 of admission to our ICU between March 1st and May 30th, 2020. Data was used to calculate APACHE IV, MEWS, and mSOFA for each patient. Student t test was used to compare means. The C statistic was calculated as a measure of the overall strength of prediction for both CSS and APACHE IV. Receiver-operating characteristic (ROC) curves were used to assess the mortality predictions.

RESULTS:

A total of 79 patients with COVID-19 were included, with 50 survivors (S) and 29 nonsurvivors (NS);mortality rate of 36.7 %. Compared to S, NS were older (70 ± 14 vs 61 ± 14, p = 0.0001), had higher APACHE IV scores (79 ± 37 vs 51 ± 23, p = 0.0001), similar MEWS (3.2 ± 2.2 vs 2.9 ± 1.9, p = 0.4), and higher mSOFA (4.3 ± 3.7 vs 3.0 ± 2.6, p = 0.01). Estimating the ROC area under the curve (AUC) showed that APACHE IV was a significantly better predictor of hospital mortality compared to MEWS or mSOFA (AUC = 0.78 ± 0.05 for APACHE IV compared to 0.60 ± 0.04 for MEWS [p < 0.0001], and compared to 0.66 +/- 0.04 for mSOFA [p = 0.0001]).

CONCLUSIONS:

APACHE IV was a better predictor of mortality than either MEWS or mSOFA in patients with COVID-19 admitted to ICU. These findings should be further investigated in large multicenter prospective studies.

Full text: Available Collection: Databases of international organizations Database: EMBASE Type of study: Prognostic study Language: English Journal: Critical Care Medicine Year: 2021 Document Type: Article

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Full text: Available Collection: Databases of international organizations Database: EMBASE Type of study: Prognostic study Language: English Journal: Critical Care Medicine Year: 2021 Document Type: Article