Development and validation of a prediction model for 30-day mortality in hospitalised patients with COVID-19: the COVID-19 SEIMC score.

J Berenguer, AM Borobia, P Ryan, J Rodríguez-Baño, JM Bellón, I Jarrín, J Carratalà, J Pachón, AJ Carcas, M Yllescas, JR Arribas, COVID-19@Spain and COVID@HULP Study Groups, Natividad Benito

Research output: Contribution to journalArticleResearchpeer-review

7 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)920-929
Number of pages10
JournalThorax
Volume76
Issue number9
DOIs
Publication statusPublished - 25 Feb 2021

Keywords

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • COVID-19/complications
  • Dyspnea/etiology
  • Female
  • Glomerular Filtration Rate
  • Hospital Mortality
  • Humans
  • Inpatients/statistics & numerical data
  • Logistic Models
  • Lymphocyte Count
  • Male
  • Middle Aged
  • Neutrophils
  • Oxygen/blood
  • ROC Curve
  • Risk Factors
  • SARS-CoV-2
  • Sex Factors
  • viral infection
  • emergency medicine
  • critical care
  • pneumonia
  • respiratory infection
  • INDIVIDUAL PROGNOSIS
  • DIAGNOSIS TRIPOD
  • clinical epidemiology
  • TOOL

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