Discriminant Ability of In-Hospital Mortality Based on Prognostic Scores of Elderly Patients with COVID-19: A Taiwan Medical Center Study

ABSTRACT

Introduction: The coronavirus disease 2019 (COVID-19) has brought excessive patients in emergency departments. Several COVID-19 prediction scores have been developed to aid in the patient disposition of emergency physicians. This study aimed to validate different COVID-19 prediction scores. Method: ???DynaMed??? was used to retrieve high-quality COVID-19 prediction scores for the evaluation of in-hospital mortality rate. SEIMC score, 4C-Mortality score, SOARS score, and Veterans Health Administration COVID-19 (VACO) Index were selected. A retrospective, single-center study was done on elderly patients hospitalized for COVID-19 from May 2021 to July 2021 in MacKay Memorial Hospital. Patients who were (I) negative for COVID-19 examination, (II) aged 65 years old, (III) previously infected with COVID-19 and de-isolated (IV) hospital-acquired COVID-19 infection, (V) not admitted for hospitalization, and (VI) with missing of demographic characteristics were excluded. The area under the receiver operating characteristic curves (AUC) was computed to predict the in-hospital mortality rate. Result: Of 66,090 patients who underwent COVID-19 examination in MacKay Memorial Hospital, 133 patients were included in this study, with 26 deceased patients (19.5%). Among included patients, the median age was 74.38 years and 53% patients were male. Of the selected COVID-19 prediction scores, 4C-Mortality Score (AUC = 0.8), SEIMC score (AUC = 0.75), and SOARS score (AUC = 0.72) contained a good prognostic value, with an AUC 0.70. VACO index demonstrated less predictive value (AUC = 0.61). Conclusion: COVID-19 prediction scores were validated, and it was found that 4C-Mortality Score, SEIMC score, and SOARS score performed well in predicting the in-hospital mortality rate of elderly patients with COVID-19, and 4C-Mortality score is best appreciated.