tetano
Editor, Senior Moderator
J Am Coll Emerg Physicians Open
. 2020 Oct 15;10.1002/emp2.12259.
doi: 10.1002/emp2.12259. Online ahead of print.
The low-harm score for predicting mortality in patients diagnosed with COVID-19: A multicentric validation study
Adrian Soto-Mota[SUP] 1 [/SUP], Braulio A Marfil-Garza[SUP] 2 [/SUP], Erick Mart?nez Rodr?guez[SUP] 2 [/SUP], Jos? Omar Barreto Rodr?guez[SUP] 3 [/SUP], Alicia Estela L?pez Romo[SUP] 4 [/SUP], Paolo Alberti Minutti[SUP] 5 [/SUP], Juan Vicente Alejandre Loya[SUP] 6 [/SUP], F?lix Emmanuel P?rez Talavera[SUP] 6 [/SUP], Freddy Jos? ?vila Cervera[SUP] 7 [/SUP], Adriana Velazquez Burciaga[SUP] 8 [/SUP], Oscar Morado Aramburo[SUP] 9 [/SUP], Luis Alberto Pi?a Olgu?n[SUP] 10 [/SUP], Adrian Soto-Rodr?guez[SUP] 11 [/SUP], Andr?s Casta?eda Prado[SUP] 12 [/SUP], Patricio Santill?n Doherty[SUP] 3 [/SUP], Juan O Galindo[SUP] 4 [/SUP], Luis Alberto Gu?zar Garc?a[SUP] 5 [/SUP], Daniel Hern?ndez Gordillo[SUP] 6 [/SUP], Juan Guti?rrez Mej?a[SUP] 2 [/SUP]
Affiliations
Abstract
Objective: We sought to determine the accuracy of the LOW-HARM score (Lymphopenia, Oxygen saturation, White blood cells, Hypertension, Age, Renal injury, and Myocardial injury) for predicting death from coronavirus disease 2019) COVID-19.
Methods: We derived the score as a concatenated Fagan's nomogram for Bayes theorem using data from published cohorts of patients with COVID-19. We validated the score on 400 consecutive COVID-19 hospital admissions (200 deaths and 200 survivors) from 12 hospitals in Mexico. We determined the sensitivity, specificity, and predictive values of LOW-HARM for predicting hospital death.
Results: LOW-HARM scores and their distributions were significantly lower in patients who were discharged compared to those who died during their hospitalization 5 (SD: 14) versus 70 (SD: 28). The overall area under the curve for the LOW-HARM score was 0.96, (95% confidence interval: 0.94-0.98). A cutoff > 65 points had a specificity of 97.5% and a positive predictive value of 96%.
Conclusions: The LOW-HARM score measured at hospital admission is highly specific and clinically useful for predicting mortality in patients with COVID-19.
Keywords: COVID‐19; SARS‐COV‐2; mortality; prediction; score; survival.
. 2020 Oct 15;10.1002/emp2.12259.
doi: 10.1002/emp2.12259. Online ahead of print.
The low-harm score for predicting mortality in patients diagnosed with COVID-19: A multicentric validation study
Adrian Soto-Mota[SUP] 1 [/SUP], Braulio A Marfil-Garza[SUP] 2 [/SUP], Erick Mart?nez Rodr?guez[SUP] 2 [/SUP], Jos? Omar Barreto Rodr?guez[SUP] 3 [/SUP], Alicia Estela L?pez Romo[SUP] 4 [/SUP], Paolo Alberti Minutti[SUP] 5 [/SUP], Juan Vicente Alejandre Loya[SUP] 6 [/SUP], F?lix Emmanuel P?rez Talavera[SUP] 6 [/SUP], Freddy Jos? ?vila Cervera[SUP] 7 [/SUP], Adriana Velazquez Burciaga[SUP] 8 [/SUP], Oscar Morado Aramburo[SUP] 9 [/SUP], Luis Alberto Pi?a Olgu?n[SUP] 10 [/SUP], Adrian Soto-Rodr?guez[SUP] 11 [/SUP], Andr?s Casta?eda Prado[SUP] 12 [/SUP], Patricio Santill?n Doherty[SUP] 3 [/SUP], Juan O Galindo[SUP] 4 [/SUP], Luis Alberto Gu?zar Garc?a[SUP] 5 [/SUP], Daniel Hern?ndez Gordillo[SUP] 6 [/SUP], Juan Guti?rrez Mej?a[SUP] 2 [/SUP]
Affiliations
- PMID: 33230506
- PMCID: PMC7675373
- DOI: 10.1002/emp2.12259
Abstract
Objective: We sought to determine the accuracy of the LOW-HARM score (Lymphopenia, Oxygen saturation, White blood cells, Hypertension, Age, Renal injury, and Myocardial injury) for predicting death from coronavirus disease 2019) COVID-19.
Methods: We derived the score as a concatenated Fagan's nomogram for Bayes theorem using data from published cohorts of patients with COVID-19. We validated the score on 400 consecutive COVID-19 hospital admissions (200 deaths and 200 survivors) from 12 hospitals in Mexico. We determined the sensitivity, specificity, and predictive values of LOW-HARM for predicting hospital death.
Results: LOW-HARM scores and their distributions were significantly lower in patients who were discharged compared to those who died during their hospitalization 5 (SD: 14) versus 70 (SD: 28). The overall area under the curve for the LOW-HARM score was 0.96, (95% confidence interval: 0.94-0.98). A cutoff > 65 points had a specificity of 97.5% and a positive predictive value of 96%.
Conclusions: The LOW-HARM score measured at hospital admission is highly specific and clinically useful for predicting mortality in patients with COVID-19.
Keywords: COVID‐19; SARS‐COV‐2; mortality; prediction; score; survival.