Development and validation of a prediction model for 30-day mortality in hospitalised patients with COVID-19: the COVID-19 SEIMC score
Por:
Berenguer, J, Borobia, AM, Ryan, P, Rodriguez-Bano, J, Bellon, JM, Jarrin, I, Carratala, J, Pachon, J, Carcas, AJ, Yllescas, M, Arribas, JR, López-Contreras J., Pascual, P., Pomar V., Rabella N., Benito N., Domingo P., Bonfill X., Mancebo J., MARTIN VEGA, ALBERTO
Publicada:
1 sep 2021
Resumen:
Objective To develop and validate a prediction model of mortality in patients with COVID-19 attending hospital emergency rooms. Design Multivariable prognostic prediction model. Setting 127 Spanish hospitals. Participants Derivation (DC) and external validation (VC) cohorts were obtained from multicentre and single-centre databases, including 4035 and 2126 patients with confirmed COVID-19, respectively. Interventions Prognostic variables were identified using multivariable logistic regression. Main outcome measures 30-day mortality. Results Patients' characteristics in the DC and VC were median age 70 and 61 years, male sex 61.0% and 47.9%, median time from onset of symptoms to admission 5 and 8 days, and 30-day mortality 26.6% and 15.5%, respectively. Age, low age-adjusted saturation of oxygen, neutrophil-to-lymphocyte ratio, estimated glomerular filtration rate by the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation, dyspnoea and sex were the strongest predictors of mortality. Calibration and discrimination were satisfactory with an area under the receiver operating characteristic curve with a 95% CI for prediction of 30-day mortality of 0.822 (0.806-0.837) in the DC and 0.845 (0.819-0.870) in the VC. A simplified score system ranging from 0 to 30 to predict 30-day mortality was also developed. The risk was considered to be low with 0-2 points (0%-2.1%), moderate with 3-5 (4.7%-6.3%), high with 6-8 (10.6%-19.5%) and very high with 9-30 (27.7%-100%). Conclusions A simple prediction score, based on readily available clinical and laboratory data, provides a useful tool to predict 30-day mortality probability with a high degree of accuracy among hospitalised patients with COVID-19.
Filiaciones:
Berenguer, J:
Hosp Gen Univ Gregorio Maranon, Inst Invest Sanitaria Gregorio Maranon IiSGM, Clin Microbiol & Infect Dis, Madrid, Spain
Borobia, AM:
Univ Autonoma Madrid, Inst Invest Hosp Univ La Paz IdiPAZ, Hosp Univ La Paz, Clin Pharmacol, Madrid, Spain
Ryan, P:
Hosp Univ Infanta Leonor, Inst Invest Sanitaria Gregorio Maranon IiSGM, Internal Med Serv, Infect Dis, Madrid, Spain
Rodriguez-Bano, J:
Univ Seville, Hosp Univ Virgen Macarena, Inst Biomed Sevilla IBiS, Infect Dis & Microbiol Unit,Dept Med, Seville, Spain
Bellon, JM:
Hosp Gen Univ Gregorio Maranon, Inst Invest Sanitaria Gregorio Maranon IiSGM, Fdn Invest Biomed, Madrid, Spain
Jarrin, I:
Inst Hlth Carlos III, Natl Ctr Epidemiol, Madrid, Comunidad De Ma, Spain
Carratala, J:
Univ Barcelona, Hosp Univ Bellvitge, Inst Invest Biomed Bellvitge IDIBELL, Infect Dis, Barcelona, Spain
Pachon, J:
Univ Seville, Hosp Univ Virgen del Rocio, Inst Biomed Sevilla IBiS, Dept Med,Infect Dis, Seville, Spain
Carcas, AJ:
Univ Autonoma Madrid, Inst Invest Hosp Univ La Paz IdiPAZ, Hosp Univ La Paz, Clin Pharmacol, Madrid, Spain
Yllescas, M:
Fdn SEIMC GESIDA, Madrid, Spain
Arribas, JR:
Hosp Univ La Paz, Inst Invest Hosp Univ La Paz IdiPAZ, Infect Dis Unit, Internal Med Serv, Madrid, Spain
López-Contreras J.:
Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), Sant Quintí 77-79, 08041 Barcelona, Spain
Pascual, P.:
Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), Sant Quintí 77-79, 08041 Barcelona, Spain
Pomar V.:
Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), Sant Quintí 77-79, 08041 Barcelona, Spain
Rabella N.:
Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), Sant Quintí 77-79, 08041 Barcelona, Spain
Benito N.:
Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), Sant Quintí 77-79, 08041 Barcelona, Spain
Domingo P.:
Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), Sant Quintí 77-79, 08041 Barcelona, Spain
Bonfill X.:
Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), Sant Quintí 77-79, 08041 Barcelona, Spain
Mancebo J.:
Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), Sant Quintí 77-79, 08041 Barcelona, Spain
MARTIN VEGA, ALBERTO:
Instituto de Investigación Sanitaria del Hospital Universitario La Paz, Madrid, Spain
hybrid, Green Published
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