Haji Aghajani Mohammad, Sistanizad Mohammad, Pourhoseingholi Asma, Asadpoordezaki Ziba, Taherpour Niloufar
Prevention of Cardiovascular Disease Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Clin Epidemiol Glob Health. 2021 Oct-Dec;12:100871. doi: 10.1016/j.cegh.2021.100871. Epub 2021 Oct 6.
The aim of this study is to develop and validate a scoring system as a tool for predicting the in-hospital mortality in COVID-19 patients in early stage of disease.
This retrospective cohort study, conducted on 893 COVID-19 patients in Tehran from February 18 to July 20, 2020. Potential factors were chosen via stepwise selection and multivariable logistic regression model. Cross-validation method was employed to assess the predictive performance of the model as well as the scoring system such as discrimination, calibration, and validity indices.
The COVID-19 patients' median age was 63 yrs (54.98% male) and 233 (26.09%) patients expired during the study. The scoring system was developed based on 8 selected variables: age ≥55 yrs (OR = 5.67, 95% CI: 3.25-9.91), males (OR = 1.51, 95% CI: 1.007-2.29), ICU need (OR = 16.32, 95% CI 10.13-26.28), pulse rate >90 (OR = 1.89, 95% CI: 1.26-2.83), lymphocytes <17% (OR = 2.33, 95%CI: 1.54-3.50), RBC ≤4, 10 /L (OR = 2.10, 95% CI: 1.35-3.26), LDH >700 U/L (OR = 1.68, 95%CI: 1.13-2.51) and troponin I level >0.03 ng/mL (OR = 1.75, 95%CI: 1.17-2.62). The AUC and the accuracy of scoring system after cross-validation were 79.4% and 79.89%, respectively.
This study showed that developed scoring system has a good performance and can use to help physicians for identifying high-risk patients in early stage of disease
本研究的目的是开发并验证一种评分系统，作为预测COVID-19患者疾病早期院内死亡率的工具。
这项回顾性队列研究于2020年2月18日至7月20日在德黑兰的893例COVID-19患者中进行。通过逐步选择和多变量逻辑回归模型选择潜在因素。采用交叉验证方法评估模型以及评分系统的预测性能，如区分度、校准度和有效性指标。
COVID-19患者的中位年龄为63岁（男性占54.98%），233例（26.09%）患者在研究期间死亡。评分系统基于8个选定变量开发：年龄≥55岁（OR = 5.67，95%CI：3.25 - 9.91）、男性（OR = 1.51，95%CI：1.007 - 2.29）、需要入住重症监护病房（ICU）（OR = 16.32，95%CI 10.13 - 26.28）、脉搏率>90（OR = 1.89，95%CI：1.26 - 2.83）、淋巴细胞<17%（OR = 2.33，95%CI：1.54 - 3.50）、红细胞计数≤4.10¹²/L（OR = 2.10，95%CI：1.35 - 3.26）、乳酸脱氢酶（LDH）>700 U/L（OR = 1.68，95%CI：1.13 - 2.51）和肌钙蛋白I水平>0.03 ng/mL（OR = 1.75，95%CI：1.17 - 2.62）。交叉验证后评分系统的曲线下面积（AUC）和准确率分别为79.4%和79.89%。
本研究表明，所开发的评分系统具有良好的性能，可用于帮助医生在疾病早期识别高危患者。
