Predicting In‐Hospital Mortality in COVID ‐19 Older Patients with Specifically Developed Scores
Autor: | Lorenzo Maria Vetrone, Mariangela Antonelli, Giuseppe De Matteis, Alessandro BUONOMO, Antonio Gasbarrini, Rosario Landi, Maurizio Sanguinetti, Francesco Antonio Mancarella, Riccardo Inchingolo, Francesco Santopaolo, Silvia Bosello, Claudio Sandroni, Caterina Guidone, Vincenzo Bove, Carlo Romano Settanni, Raffaele Iorio, Annamaria Carnicelli, Andrea FLEX, Cristiano Caruso, Benedetta Simeoni, Elisabetta Nardella, Lucia Cerrito, Nicola Acampora, Maurizio Gabrielli, Maria Valeria Matteo, Angelo Carfì, Laura Gigante, Domenico Fusco, Valerio Pontecorvi, Matteo Tosato, Paolo Santini, Antonella Giampietro, Davide Moschese, Martina Petrucci, Francesco De Vito, Dario Bruno, LUCREZIA VERARDI, Tommaso Schepis, Elisa Gremese, Francesco Lombardi, Luca Sabia, Marcello Covino, Anna Maria Martone, Leonardo Stella, Gerlando Natalello, Marcello Candelli, Fabio Del Zompo, Giuseppe Parrinello, Giulia Pignataro, Gabriele Rumi, Federico Rosa, Emanuele Marzetti |
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Rok vydání: | 2020 |
Předmět: |
Male
2019-20 coronavirus outbreak medicine.medical_specialty Coronavirus disease 2019 (COVID-19) Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Critical Illness ISARIC‐ 030204 cardiovascular system & hematology Severity of Illness Index COVID‐GRAM Cohort Studies 03 medical and health sciences 0302 clinical medicine GRAM Older patients COVID‐19 Internal medicine Settore MED/41 - ANESTESIOLOGIA ISARIC‐4C qCSI Humans Medicine Hospital Mortality 030212 general & internal medicine Letters to the Editor 4C Letter to the Editor Aged Retrospective Studies Framingham Risk Score In hospital mortality business.industry Brief Report Settore MED/09 - MEDICINA INTERNA COVID-19 Retrospective cohort study NEWS Emergency department Middle Aged Early warning score Italy Early Warning Score Emergency medicine Cohort Brief Reports Female Geriatrics and Gerontology Emergency Service Hospital business |
Zdroj: | Journal of the American Geriatrics Society |
ISSN: | 1532-5415 0002-8614 |
Popis: | 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. PARTICIPANTS: We reviewed the clinical records of the confirmed COVID-19 patients aged 60 years or more consecutively admitted to our ED over a 6-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. 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). 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. CONCLUSION: 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. |
Databáze: | OpenAIRE |
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