A novel severity score to predict inpatient mortality in COVID-19 patients.
A novel severity score to predict inpatient mortality in COVID-19 patients.
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DOI：
10.1038/s41598-020-73962-9
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发表时间：
2020-10-07
影响因子：
4.6
通讯作者：
Eskandar EN
中科院分区：
文献类型：
--
作者：
Altschul DJ;Unda SR;Benton J;de la Garza Ramos R;Cezayirli P;Mehler M;Eskandar EN
新冠肺炎通常是轻微的和自我限制的，但在相当一部分患者中，这种疾病是严重的和致命的。确定哪些患者有严重疾病或死亡的高风险，对于做出适当的临床决策是至关重要的。我们提出了一种专门针对新冠肺炎的新的严重性评分，以帮助预测疾病的严重性和死亡率。纳入4711例确诊为SARS-CoV-2感染的患者。我们使用队列的前一半(n = 2355名患者)，通过Logistic回归和自举方法建立了风险模型。通过计算受试者工作特征曲线(AUC)下的面积来评估风险模型的区分能力。严重程度评分在2356名患者中进行了验证。死亡率在衍生队列中为26.4%，在验证队列中为22.4%。制定了新冠肺炎严重程度评分，范围为0至10，包括年龄、血氧饱和度、平均动脉压、血尿素氮、C反应蛋白和国际标准化比率。在衍生队列中进行ROC曲线分析，在验证队列中，AUC值为0.824(95%可信区间0.814-0.851)，AUC值为0.798(95%可信区间0.789-0.818)。此外，根据危险分类，新冠肺炎严重程度评分低(0~3)、中(4~6)和高(7~10)的患者死亡的概率分别为11.8%、39%和78%。这一开发和验证的新型新冠肺炎严重程度评分将有助于医生预测高峰期的死亡率。
COVID-19 is commonly mild and self-limiting, but in a considerable portion of patients the disease is severe and fatal. Determining which patients are at high risk of severe illness or mortality is essential for appropriate clinical decision making. We propose a novel severity score specifically for COVID-19 to help predict disease severity and mortality. 4711 patients with confirmed SARS-CoV-2 infection were included. We derived a risk model using the first half of the cohort (n = 2355 patients) by logistic regression and bootstrapping methods. The discriminative power of the risk model was assessed by calculating the area under the receiver operating characteristic curves (AUC). The severity score was validated in a second half of 2356 patients. Mortality incidence was 26.4% in the derivation cohort and 22.4% in the validation cohort. A COVID-19 severity score ranging from 0 to 10, consisting of age, oxygen saturation, mean arterial pressure, blood urea nitrogen, C-Reactive protein, and the international normalized ratio was developed. A ROC curve analysis was performed in the derivation cohort achieved an AUC of 0.824 (95% CI 0.814–0.851) and an AUC of 0.798 (95% CI 0.789–0.818) in the validation cohort. Furthermore, based on the risk categorization the probability of mortality was 11.8%, 39% and 78% for patient with low (0–3), moderate (4–6) and high (7–10) COVID-19 severity score. This developed and validated novel COVID-19 severity score will aid physicians in predicting mortality during surge periods.
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影响因子：
3.7
作者：
Hayes T;Usami S;Jacobucci R;McArdle JJ
通讯作者：
McArdle JJ
DOI：
10.1001/jama.2020.6775
发表时间：
2020-01-01
期刊：
JAMA, Journal of the American Medical Association
影响因子：
--
作者：
Richardson, Safiya;Hirsch, Jamie S.;,
通讯作者：
,
影响因子：
19.6
作者：
Cheng, Yichun;Luo, Ran;Xu, Gang
通讯作者：
Xu, Gang
影响因子：
38.9
作者：
Sivula, M;Tallgren, M;Pettilä, V
通讯作者：
Pettilä, V
影响因子：
120.7
作者：
Grasselli, Giacomo;Zangrillo, Alberto;Pesenti, Antonio
通讯作者：
Pesenti, Antonio