Torres-Macho Juan, Ryan Pablo, Valencia Jorge, Pérez-Butragueño Mario, Jiménez Eva, Fontán-Vela Mario, Izquierdo-García Elsa, Fernandez-Jimenez Inés, Álvaro-Alonso Elena, Lazaro Andrea, Alvarado Marta, Notario Helena, Resino Salvador, Velez-Serrano Daniel, Meca Alejandro
University Hospital Infanta Leonor, 28031 Madrid, Spain.
Department of Mathematics, Complutense de Madrid University (UCM), 28040 Madrid, Spain.
J Clin Med. 2020 Sep 23;9(10):3066. doi: 10.3390/jcm9103066.
UNLABELLED: This study aimed to build an easily applicable prognostic model based on routine clinical, radiological, and laboratory data available at admission, to predict mortality in coronavirus 19 disease (COVID-19) hospitalized patients. METHODS: We retrospectively collected clinical information from 1968 patients admitted to a hospital. We built a predictive score based on a logistic regression model in which explicative variables were discretized using classification trees that facilitated the identification of the optimal sections in order to predict inpatient mortality in patients admitted with COVID-19. These sections were translated into a score indicating the probability of a patient's death, thus making the results easy to interpret. RESULTS: Median age was 67 years, 1104 patients (56.4%) were male, and 325 (16.5%) died during hospitalization. Our final model identified nine key features: age, oxygen saturation, smoking, serum creatinine, lymphocytes, hemoglobin, platelets, C-reactive protein, and sodium at admission. The discrimination of the model was excellent in the training, validation, and test samples (AUC: 0.865, 0.808, and 0.883, respectively). We constructed a prognostic scale to determine the probability of death associated with each score. CONCLUSIONS: We designed an easily applicable predictive model for early identification of patients at high risk of death due to COVID-19 during hospitalization.
未标注:本研究旨在基于入院时可用的常规临床、放射学和实验室数据构建一个易于应用的预后模型,以预测冠状病毒19疾病(COVID-19)住院患者的死亡率。 方法:我们回顾性收集了一家医院收治的1968例患者的临床信息。我们基于逻辑回归模型构建了一个预测评分,其中解释变量使用分类树进行离散化,这有助于识别最佳分段,以预测COVID-19入院患者的住院死亡率。这些分段被转化为一个表明患者死亡概率的评分,从而使结果易于解释。 结果:中位年龄为67岁,1104例患者(56.4%)为男性,325例(16.5%)在住院期间死亡。我们的最终模型确定了九个关键特征:年龄、血氧饱和度、吸烟、血清肌酐、淋巴细胞、血红蛋白、血小板、C反应蛋白和入院时的钠。该模型在训练、验证和测试样本中的辨别力极佳(AUC分别为0.865、0.808和0.883)。我们构建了一个预后量表来确定与每个评分相关的死亡概率。 结论:我们设计了一个易于应用的预测模型,用于在住院期间早期识别因COVID-19有高死亡风险的患者。
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