Head-to-head comparison of six warning scores to predict mortality and clinical impairment in COVID-19 patients in emergency department.

Autor: de Santos Castro PÁ; Servicio de Urgencias, Hospital Clínico Universitario de Valladolid, Gerencia Regional de Salud de Castilla Y León (SACYL), Valladolid, Spain., Martín-Rodríguez F; Facultad de Medicina, Centro de Simulación Clínica Avanzada, Universidad de Valladolid, Avda. Ramón Y Cajal, 7, 47003, Valladolid, Spain. francisco.martin.rodriguez@uva.es.; Unidad Móvil de Emergencias Valladolid I, Gerencia de Emergencias Sanitarias, Gerencia Regional de Salud de Castilla Y León (SACYL), Valladolid, Spain. francisco.martin.rodriguez@uva.es., Arribas LTP; Servicio de Urgencias, Hospital Clínico Universitario de Valladolid, Gerencia Regional de Salud de Castilla Y León (SACYL), Valladolid, Spain., Sánchez DZ; Servicio de Urgencias, Hospital Clínico Universitario de Valladolid, Gerencia Regional de Salud de Castilla Y León (SACYL), Valladolid, Spain., Sanz-García A; Facultad de Ciencias de La Salud, Universidad de Castilla La Mancha, Avda. Real Fábrica de Seda, s/n, 45600, Talavera de La Reina, Toledo, Spain. ancor.sanz@gmail.com., Del Águila TGV; Servicio de Urgencias, Hospital Clínico Universitario de Valladolid, Gerencia Regional de Salud de Castilla Y León (SACYL), Valladolid, Spain., Izquierdo PG; Servicio de Urgencias, Hospital Clínico Universitario de Valladolid, Gerencia Regional de Salud de Castilla Y León (SACYL), Valladolid, Spain., de Santos Sánchez S; Facultad de Medicina, Centro de Simulación Clínica Avanzada, Universidad de Valladolid, Avda. Ramón Y Cajal, 7, 47003, Valladolid, Spain., Del Pozo Vegas C; Servicio de Urgencias, Hospital Clínico Universitario de Valladolid, Gerencia Regional de Salud de Castilla Y León (SACYL), Valladolid, Spain.; Facultad de Medicina, Centro de Simulación Clínica Avanzada, Universidad de Valladolid, Avda. Ramón Y Cajal, 7, 47003, Valladolid, Spain.
Jazyk: angličtina
Zdroj: Internal and emergency medicine [Intern Emerg Med] 2023 Nov; Vol. 18 (8), pp. 2385-2395. Date of Electronic Publication: 2023 Jul 26.
DOI: 10.1007/s11739-023-03381-x
Abstrakt: The aim was to evaluate the ability of six risk scores (4C, CURB65, SEIMC, mCHOSEN, QuickCSI, and NEWS2) to predict the outcome of patients with COVID-19 during the sixth pandemic wave in Spain. A retrospective observational study was performed to review the electronic medical records in patients ≥ 18 years of age who consulted consecutively in an emergency department with COVID-19 diagnosis throughout 2 months during the sixth pandemic wave. Clinical-epidemiological variables, comorbidities, and their respective outcomes, such as 30-day in-hospital mortality and clinical deterioration risk (a combined outcome considering: mechanical ventilation, intensive care unit admission, and/or 30-day in-hospital mortality), were calculated. The area under the curve for each risk score was calculated, and the resulting curves were compared by the Delong test, concluding with a decision curve analysis. A total of 626 patients (median age 79 years; 49.8% female) fulfilled the inclusion criteria. Two hundred and ninety-three patients (46.8%) had two or more comorbidities. Clinical deterioration risk criteria were present in 10.1% (63 cases), with a 30-day in-hospital mortality rate of 6.2% (39 cases). Comparison of the results showed that score 4C presented the best results for both outcome variables, with areas under the curve for mortality and clinical deterioration risk of 0.931 (95% CI 0.904-0.957) and 0.871 (95% CI 0.833-0.910) (both p < 0.001). The 4C Mortality Score proved to be the best score for predicting mortality or clinical deterioration risk among patients with COVID-19 attended in the emergency department in the following 30 days.
(© 2023. The Author(s), under exclusive licence to Società Italiana di Medicina Interna (SIMI).)
Databáze: MEDLINE
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