tetano
Editor, Senior Moderator
J Am Geriatr Soc
. 2020 Nov 16.
doi: 10.1111/jgs.16956. Online ahead of print.
PREDICTING IN-HOSPITAL MORTALITY IN COVID-19 OLDER PATIENTS WITH SPECIFICALLY DEVELOPED SCORES
Marcello Covino[SUP] 1 [/SUP], Giuseppe De Matteis[SUP] 2 [/SUP], Maria Livia Burzo[SUP] 2 [/SUP], Andrea Russo[SUP] 3 [/SUP], Evelina Forte[SUP] 1 [/SUP], Annamaria Carnicelli[SUP] 1 [/SUP], Andrea Piccioni[SUP] 1 [/SUP], Benedetta Simeoni[SUP] 1 [/SUP], Antonio Gasbarrini[SUP] 4 5 [/SUP], Francesco Franceschi[SUP] 1 5 [/SUP], Claudio Sandroni[SUP] 6 5 [/SUP], GEMELLI AGAINST COVID-19 Group
Collaborators, Affiliations
Abstract
Background/objectives: Several scoring systems have been specifically developed for risk stratification in COVID-19 patients.
Design: We compared, in a cohort of confirmed COVID-19 older patients, three specifically developed scores with a previously established early warning score. Main endpoint was all causes in-hospital death.
Setting: This is a single-center, retrospective observational study, conducted in the Emergency Department (ED) of an urban teaching hospital, referral center for COVID-19.
Measurements: International Severe Acute Respiratory Infection Consortium Clinical Characterization Protocol-Coronavirus Clinical Characterization Consortium (ISARIC-4C) score, COVID-GRAM Critical Illness Risk Score (COVID-GRAM), quick COVID-19 Severity Index (qCSI), National Early Warning Score (NEWS).
Participants: We reviewed the clinical records of the confirmed COVID-19 patients aged ≥60 years consecutively admitted to our ED over a six-week period (March 1st to April 15th, 2020). A total of 210 patients, aged between 60 and 98 years were included in the study cohort.
Results: Median age was 74 [67-82] and 133 (63.3%) were males. Globally, 42 patients (20.0%) deceased. All the score evaluated showed a fairly good predictive value with respect to in-hospital death. The ISARIC-4C score had the highest area under ROC curve (AUROC) 0.799 [0.738-0.851], followed by the COVID-GRAM 0.785 [0.723-0.838], NEWS 0.764 [0.700-0.819] and qCSI 0.749 [0.685-0.806]. However, these differences were not statistical significant.
Conclusions: Among the evaluated scores, the ISARIC-4C and the COVID-GRAM, calculated at ED admission, had the best performance, although the qCSI had similar efficacy by evaluating only three items. However, the NEWS, already widely validated in clinical practice, had a similar performance and could be appropriate for older patients with COVID-19. This article is protected by copyright. All rights reserved.
Keywords: COVID-19; COVID-GRAM; ISARIC-4C; NEWS; qCSI.
. 2020 Nov 16.
doi: 10.1111/jgs.16956. Online ahead of print.
PREDICTING IN-HOSPITAL MORTALITY IN COVID-19 OLDER PATIENTS WITH SPECIFICALLY DEVELOPED SCORES
Marcello Covino[SUP] 1 [/SUP], Giuseppe De Matteis[SUP] 2 [/SUP], Maria Livia Burzo[SUP] 2 [/SUP], Andrea Russo[SUP] 3 [/SUP], Evelina Forte[SUP] 1 [/SUP], Annamaria Carnicelli[SUP] 1 [/SUP], Andrea Piccioni[SUP] 1 [/SUP], Benedetta Simeoni[SUP] 1 [/SUP], Antonio Gasbarrini[SUP] 4 5 [/SUP], Francesco Franceschi[SUP] 1 5 [/SUP], Claudio Sandroni[SUP] 6 5 [/SUP], GEMELLI AGAINST COVID-19 Group
Collaborators, Affiliations
- PMID: 33197278
- DOI: 10.1111/jgs.16956
Abstract
Background/objectives: Several scoring systems have been specifically developed for risk stratification in COVID-19 patients.
Design: We compared, in a cohort of confirmed COVID-19 older patients, three specifically developed scores with a previously established early warning score. Main endpoint was all causes in-hospital death.
Setting: This is a single-center, retrospective observational study, conducted in the Emergency Department (ED) of an urban teaching hospital, referral center for COVID-19.
Measurements: International Severe Acute Respiratory Infection Consortium Clinical Characterization Protocol-Coronavirus Clinical Characterization Consortium (ISARIC-4C) score, COVID-GRAM Critical Illness Risk Score (COVID-GRAM), quick COVID-19 Severity Index (qCSI), National Early Warning Score (NEWS).
Participants: We reviewed the clinical records of the confirmed COVID-19 patients aged ≥60 years consecutively admitted to our ED over a six-week period (March 1st to April 15th, 2020). A total of 210 patients, aged between 60 and 98 years were included in the study cohort.
Results: Median age was 74 [67-82] and 133 (63.3%) were males. Globally, 42 patients (20.0%) deceased. All the score evaluated showed a fairly good predictive value with respect to in-hospital death. The ISARIC-4C score had the highest area under ROC curve (AUROC) 0.799 [0.738-0.851], followed by the COVID-GRAM 0.785 [0.723-0.838], NEWS 0.764 [0.700-0.819] and qCSI 0.749 [0.685-0.806]. However, these differences were not statistical significant.
Conclusions: Among the evaluated scores, the ISARIC-4C and the COVID-GRAM, calculated at ED admission, had the best performance, although the qCSI had similar efficacy by evaluating only three items. However, the NEWS, already widely validated in clinical practice, had a similar performance and could be appropriate for older patients with COVID-19. This article is protected by copyright. All rights reserved.
Keywords: COVID-19; COVID-GRAM; ISARIC-4C; NEWS; qCSI.