Absolute mortality risk assessment of COVID-19 patients: the Khorshid COVID Cohort (KCC) study

Background: Already at hospital admission, clinicians require simple tools to identify hospitalized COVID-19 patients at high risk of mortality. Such tools can significantly improve resource allocation and patient management within hospitals. From the statistical point of view, extended time-to-even...

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Detalhes bibliográficos
Autores: Marateb, Hamid Reza|||0000-0003-4408-2397, von Cube, Maja, Samí, Ramin, Javanmard, Shaghayegh Haghjooy, Mansourian Gharakozlou, Marjan, Amra, Babak, Soltaninejad, Forogh, Mortazavi, Mojgan, Adibi, Peyman, Khademi, Nilufar, Hosseini, Nastaran Sadat, Toghyani, Arash, Hassannejad, Razieh, Mañanas Villanueva, Miguel Ángel|||0000-0001-9836-6083, Binder, Harald, Wolkewitz, Martin
Formato: artículo
Fecha de publicación:2021
País:España
Recursos:Universitat Politècnica de Catalunya (UPC)
Repositorio:UPCommons. Portal del coneixement obert de la UPC
Idioma:inglés
OAI Identifier:oai:upcommons.upc.edu:2117/351820
Acesso em linha:https://hdl.handle.net/2117/351820
https://dx.doi.org/10.1186/s12874-021-01340-8
Access Level:acceso abierto
Palavra-chave:Mortality
Risk assessment
COVID-19 (Disease)
Cause-specifc hazard regression
COVID-19
Prognosis
Risk chart
Mortalitat
Avaluació del risc
COVID-19 (Malaltia)
Àrees temàtiques de la UPC::Ciències de la salut::Medicina
Àrees temàtiques de la UPC::Informàtica::Automàtica i control
Descrição
Resumo:Background: Already at hospital admission, clinicians require simple tools to identify hospitalized COVID-19 patients at high risk of mortality. Such tools can significantly improve resource allocation and patient management within hospitals. From the statistical point of view, extended time-to-event models are required to account for competing risks (discharge from hospital) and censoring so that active cases can also contribute to the analysis. // Methods: We used the hospital-based open Khorshid COVID Cohort (KCC) study with 630 COVID-19 patients from Isfahan, Iran. Competing risk methods are used to develop a death risk chart based on the following variables, which can simply be measured at hospital admission: sex, age, hypertension, oxygen saturation, and Charlson Comorbidity Index. The area under the receiver operator curve was used to assess accuracy concerning discrimination between patients discharged alive and dead. // Results: Cause-specific hazard regression models show that these baseline variables are associated with both death, and discharge hazards. The risk chart reflects the combined results of the two cause-specific hazard regression models. The proposed risk assessment method had a very good accuracy (AUC¿=¿0.872 [CI 95%: 0.835–0.910]). // Conclusions: This study aims to improve and validate a personalized mortality risk calculator based on hospitalized COVID-19 patients. The risk assessment of patient mortality provides physicians with additional guidance for making tough decisions.