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
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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