New Scoring System for Predicting Mortality in Patients with COVID-19
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Purpose: We aimed to develop a novel mortality scoring system for inpatients with COVID-19 based on simple demographic factorsand laboratory findings. Materials and Methods: We reviewed and analyzed data from patients who were admitted and diagnosed with COVID-19 at 10hospitals in Daegu, South Korea, between January and July 2020. We randomized and assigned patients to the development andvalidation groups at a 70% to 30% ratio. Each point scored for selected risk factors helped build a new mortality scoring system usingCox regression analysis. We evaluated the accuracy of the new scoring system in the development and validation groups usingthe area under the curve. Results: The development group included 1232 patients, whereas the validation group included 528 patients. In the developmentgroup, predictors for the new scoring system as selected by Cox proportional hazards model were age ≥70 years, diabetes, chronickidney disease, dementia, C-reactive protein levels >4 mg/dL, infiltration on chest X-rays at the initial diagnosis, and the need foroxygen support on admission. The areas under the curve for the development and validation groups were 0.914 [95% confidenceinterval (CI) 0.891–0.937] and 0.898 (95% CI 0.854–0.941), respectively. According to our scoring system, COVID-19 mortality was0.4% for the low-risk group (score 0–3) and 53.7% for the very high-risk group (score ≥11). Conclusion: We developed a new scoring system for quickly and easily predicting COVID-19 mortality using simple predictors. This scoring system can help physicians provide the proper therapy and strategy for each patient.
Abstract
Purpose: We aimed to develop a novel mortality scoring system for inpatients with COVID-19 based on simple demographic factorsand laboratory findings. Materials and Methods: We reviewed and analyzed data from patients who were admitted and diagnosed with COVID-19 at 10hospitals in Daegu, South Korea, between January and July 2020. We randomized and assigned patients to the development andvalidation groups at a 70% to 30% ratio. Each point scored for selected risk factors helped build a new mortality scoring system usingCox regression analysis. We evaluated the accuracy of the new scoring system in the development and validation groups usingthe area under the curve. Results: The development group included 1232 patients, whereas the validation group included 528 patients. In the developmentgroup, predictors for the new scoring system as selected by Cox proportional hazards model were age ≥70 years, diabetes, chronickidney disease, dementia, C-reactive protein levels >4 mg/dL, infiltration on chest X-rays at the initial diagnosis, and the need foroxygen support on admission. The areas under the curve for the development and validation groups were 0.914 [95% confidenceinterval (CI) 0.891–0.937] and 0.898 (95% CI 0.854–0.941), respectively. According to our scoring system, COVID-19 mortality was0.4% for the low-risk group (score 0–3) and 53.7% for the very high-risk group (score ≥11). Conclusion: We developed a new scoring system for quickly and easily predicting COVID-19 mortality using simple predictors. This scoring system can help physicians provide the proper therapy and strategy for each patient.
참고문헌 (35)
- Huang C, "Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China", Lancet, 395, pp.497~506 (2020)
- Beigel JH, "Remdesivir for the treatment of COVID-19-final report", N Engl J Med, 383, pp.1813~1826 (2020)
- Cohen MS, "Monoclonal antibodies to disrupt progression of early COVID-19 infection", N Engl J Med, 384, pp.289~291 (2021)
- RECOVERY Collaborative Group, "Dexamethasone in hospitalized patients with COVID-19", N Engl J Med, 384, pp.693~704 (2021)
- Kalil AC, "Baricitinib plus remdesivir for hospitalized adults with COVID-19", N Engl J Med, 384, pp.795~807 (2021)
- Li X, "Risk factors for severity and mortality in adult COVID-19 inpatients in Wuhan", J Allergy Clin Immunol, 146, pp.110~118 (2020)
- Lee Ji Yeon, "Risk Factors for Mortality and Respiratory Support in Elderly Patients Hospitalized with COVID-19 in Korea", Journal of Korean Medical Science, 35(23), pp.1~12 (2020), 대한의학회[DOI]
- Fang L, "Are patients with hypertension and diabetes mellitus at increased risk for COVID-19 infection?", Lancet Respir Med, 8, pp.e21~ (2020)
- Harrison SL, "Comorbidities associated with mortality in 31, 461 adults with COVID-19 in the United States : a federated electronic medical record analysis", PLoS Med, 17, pp.e1003321~ (2020)
- Zhou F, "Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China : a retrospective cohort study", Lancet, 395, pp.1054~1062 (2020)
- Kermali M, "The role of biomarkers in diagnosis of COVID-19 : a systematic review", Life Sci, 254, pp.117788~ (2020)
- Shang Y, "Scoring systems for predicting mortality for severe patients with COVID-19", EClinicalMedicine, 24, pp.100426~ (2020)
- Zhang C, "A novel scoring system for prediction of disease severity in COVID-19", Front Cell Infect Microbiol, 10, pp.318~ (2020)
- Mancilla-Galindo J, "Development and validation of the patient history COVID-19(PH-Covid19)scoring system : a multivariable prediction model of death in Mexican patients with COVID-19", Epidemiol Infect, 148, pp.e286~ (2020)
- Jang Jong Geol, "Prognostic Accuracy of the SIRS, qSOFA, and NEWS for Early Detection of Clinical Deterioration in SARS-CoV-2 Infected Patients", Journal of Korean Medical Science, 35(25), pp.1~10 (2020), 대한의학회[DOI]
- Kodama T, "Prediction of an increase in oxygen requirement of SARSCoV-2 pneumonia using three different scoring systems", J Infect Chemother, 27, pp.336~341 (2021)
- Kim Shin-Woo, "Clinical Characteristics and Outcomes of COVID-19 Cohort Patients in Daegu Metropolitan City Outbreak in 2020", Journal of Korean Medical Science, 36(1), pp.1~15 (2021), 대한의학회[DOI]
- Chen W, "Plasma CRP level is positively associated with the severity of COVID-19", Ann Clin Microbiol Antimicrob, 19, pp.18~ (2020)
- Luo X, "Prognostic value of c-reactive protein in patients with coronavirus 2019", Clin Infect Dis, 71, pp.2174~2179 (2020)
- Satici C, "Performance of pneumonia severity index and CURB65 in predicting 30-day mortality in patients with COVID-19", Int J Infect Dis, 98, pp.84~89 (2020)
- Guo S, "The moderate predictive value of serial serum CRP and PCT levels for the prognosis of hospitalized community-acquired pneumonia", Respir Res, 19, pp.193~ (2018)
- Borghesi A, "Chest X-ray severity index as a predictor of in-hospital mortality in coronavirus disease 2019 : a study of 302 patients from Italy", Int J Infect Dis, 96, pp.291~293 (2020)
- Borghesi A, "COVID-19 outbreak in Italy : experimental chest X-ray scoring system for quantifying and monitoring disease progression", Radiol Med, 125, pp.509~513 (2020)
- Maroldi R, "Which role for chest x-ray score in predicting the outcome in COVID-19 pneumonia?", Eur Radiol, 31, pp.4016~4022 (2021)
- Feng Z, "Early prediction of disease progression in COVID-19 pneumonia patients with chest CT and clinical characteristics", Nat Commun, 11, pp.4968~ (2020)
- Guan WJ, "Comorbidity and its impact on 1590 patients with COVID-19 in China : a nationwide analysis", Eur Respir J, 55, pp.2000547~ (2020)
- King JT Jr, "Development and validation of a 30-day mortality index based on pre-existing medical administrative data from 13, 323 COVID-19 patients : the Veterans Health Administration COVID-19(VACO)index", PLoS One, 15, pp.e0241825~ (2020)
- Wang Z, "Glycosylated hemoglobin is associated with systemic inflammation, hypercoagulability, and prognosis of COVID-19 patients", Diabetes Res Clin Pract, 164, pp.108214~ (2020)
- Cheng Y, "Kidney disease is associated with in-hospital death of patients with COVID-19", Kidney Int, 97, pp.829~838 (2020)
- Chen D, "Exposure to SARS-CoV-2 in a high transmission setting increases the risk of severe COVID-19 compared with exposure to a low transmission setting?", J Travel Med, 27, pp.taaa094~ (2020)
- Ji D, "Prediction for progression risk in patients with COVID-19 pneumonia : the CALL score", Clin Infect Dis, 71, pp.1393~1399 (2020)
- Grifoni E, "The CALL score for predicting outcomes in patients with COVID-19", Clin Infect Dis, 72, pp.182~183 (2021)
- Altschul DJ, "A novel severity score to predict inpatient mortality in COVID-19 patients", Sci Rep, 10, pp.16726~ (2020)
- Gue YX, "Development of a novel risk score to predict mortality in patients admitted to hospital with COVID-19", Sci Rep, 10, pp.21379~ (2020)
- Liang W, "Development and validation of a clinical risk score to predict the occurrence of critical illness in hospitalized patients with COVID-19", JAMA Intern Med, 180, pp.1081~1089 (2020)