External validation of a clinical risk score to predict hospital admission and in-hospital mortality in COVID-19 patients.
Ann Med
; 53(1): 78-86, 2021 12.
Artículo
en Inglés
| MEDLINE | ID: covidwho-804912
ABSTRACT
BACKGROUND:
Identification of patients with novel coronavirus disease 2019 (COVID-19) requiring hospital admission or at high-risk of in-hospital mortality is essential to guide patient triage and to provide timely treatment for higher risk hospitalized patients.METHODS:
A retrospective multi-centre (8 hospital) cohort at Beaumont Health, Michigan, USA, reporting on COVID-19 patients diagnosed between 1 March and 1 April 2020 was used for score validation. The COVID-19 Risk of Complications Score was automatically computed by the EHR. Multivariate logistic regression models were built to predict hospital admission and in-hospital mortality using individual variables constituting the score. Validation was performed using both discrimination and calibration.RESULTS:
Compared to Green scores, Yellow Scores (OR 5.72) and Red Scores (OR 19.1) had significantly higher odds of admission (both p < .0001). Similarly, Yellow Scores (OR 4.73) and Red Scores (OR 13.3) had significantly higher odds of in-hospital mortality than Green Scores (both p < .0001). The cross-validated C-Statistics for the external validation cohort showed good discrimination for both hospital admission (C = 0.79 (95% CI 0.77-0.81)) and in-hospital mortality (C = 0.75 (95% CI 0.71-0.78)).CONCLUSIONS:
The COVID-19 Risk of Complications Score predicts the need for hospital admission and in-hospital mortality patients with COVID-19. Key points Can an electronic health record generated risk score predict the risk of hospital admission and in-hospital mortality in patients diagnosed with coronavirus disease 2019 (COVID-19)? In both validation cohorts of 2,025 and 1,290 COVID-19, the cross-validated C-Statistics showed good discrimination for both hospital admission (C = 0.79 (95% CI 0.77-0.81)) and in-hospital mortality (C = 0.75 (95% CI 0.71-0.78)), respectively. The COVID-19 Risk of Complications Score may help predict the need for hospital admission if a patient contracts SARS-CoV-2 infection and in-hospital mortality for a hospitalized patient with COVID-19.Palabras clave
Texto completo:
Disponible
Colección:
Bases de datos internacionales
Base de datos:
MEDLINE
Asunto principal:
Neumonía Viral
/
Mortalidad Hospitalaria
/
Enfermedad Crítica
/
Infecciones por Coronavirus
/
Betacoronavirus
Tipo de estudio:
Estudio de cohorte
/
Estudio observacional
/
Estudio pronóstico
/
Ensayo controlado aleatorizado
Límite:
Adulto
/
Anciano
/
Femenino
/
Humanos
/
Masculino
/
Middle aged
Idioma:
Inglés
Revista:
Ann Med
Asunto de la revista:
Medicina
Año:
2021
Tipo del documento:
Artículo
País de afiliación:
07853890.2020.1828616
Similares
MEDLINE
...
LILACS
LIS