Medication regimen complexity (MRC-ICU) for in-hospital mortality prediction in COVID-19 patients
Hospital Pharmacy
; 2023.
Article
in English
| EMBASE | ID: covidwho-2312763
ABSTRACT
Purpose:
The medication regimen complexity-intensive care unit (MRC-ICU) score was developed prior to the existence of COVID-19. The purpose of this study was to assess if MRC-ICU could predict in-hospital mortality in patients with COVID-19. Method(s) A single-center, observational study was conducted from August 2020 to January 2021. The primary outcome of this study was the area under the receiver operating characteristic (AUROC) for in-hospital mortality for the 48-hour MRC-ICU. Age, sequential organ failure assessment (SOFA), and World Health Organization (WHO) COVID-19 Severity Classification were assessed. Logistic regression was performed to predict in-hospital mortality as well as WHO Severity Classification at 7 days. Result(s) A total of 149 patients were included. The median SOFA score was 8 (IQR 5-11) and median MRC-ICU score at 48 hours was 15 (IQR 7-21). The in-hospital mortality rate was 36% (n = 54). The AUROC for MRC-ICU was 0.71 (95% Confidence Interval (CI), 0.62-0.78) compared to 0.66 for age, 0.81 SOFA, and 0.72 for the WHO Severity Classification. In univariate analysis, age, SOFA, MRC-ICU, and WHO Severity Classification all demonstrated significant association with in-hospital mortality, while SOFA, MRC-ICU, and WHO Severity Classification demonstrated significant association with WHO Severity Classification at 7 days. In univariate analysis, all 4 characteristics showed significant association with mortality;however, only age and SOFA remained significant following multivariate analysis. Conclusion(s) In the first analysis of medication-related variables as a predictor of severity and in-hospital mortality in COVID-19, MRC-ICU demonstrated acceptable predictive ability as represented by AUROC;however, SOFA was the strongest predictor in both AUROC and regression analysis.Copyright © The Author(s) 2023.
COVID severity score; covid-19; critical care; medication regimen complexity; quality improvement; sequential organ failure assessment (SOFA); adult; article; controlled study; coronavirus disease 2019; female; human; in-hospital mortality; intensive care; intensive care unit; major clinical study; male; mortality; observational study; outcome assessment; prediction; receiver operating characteristic; Sequential Organ Failure Assessment Score; total quality management; univariate analysis; World Health Organization
Full text:
Available
Collection:
Databases of international organizations
Database:
EMBASE
Type of study:
Prognostic study
Language:
English
Journal:
Hospital Pharmacy
Year:
2023
Document Type:
Article
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