High-Dependency Unit, Department of Clinical and Experimental Medicine, Careggi University Hospital, Lg. Brambilla 3, 50134, Florence, Italy.
Intern Emerg Med. 2024 Sep;19(6):1717-1725. doi: 10.1007/s11739-024-03551-5. Epub 2024 Feb 23.
To evaluate the prognostic stratification ability of 4C Mortality Score and COVID-19 Mortality Risk Score in different age groups. Retrospective study, including all patients, presented to the Emergency Department of the University Hospital Careggi, between February, 2020 and May, 2021, and admitted for SARS-CoV2. Patients were divided into four subgroups based on the quartiles of age distribution: patients < 57 years (G1, n = 546), 57-71 years (G2, n = 508), 72-81 years (G3, n = 552), and > 82 years (G4, n = 578). We calculated the 4C Mortality Score and COVID-19 Mortality Risk Score. The end-point was in-hospital mortality. In the whole population (age 68 ± 16 years), the mortality rate was 19% (n = 424), and increased with increasing age (G1: 4%, G2: 11%, G3: 22%, and G4: 39%, p < 0.001). Both scores were higher among non-survivors than survivors in all subgroups (4C-MS, G1: 6 [3-7] vs 3 [2-5]; G2: 10 [7-11] vs 7 [5-8]; G3: 11 [10-14] vs 10 [8-11]; G4: 13 [12-15] vs 11 [10-13], all p < 0.001; COVID-19 MRS, G1: 8 [7-9] vs 9 [9-11], G2: 10 [8-11] vs 11 [10-12]; G3: 11 [10-12] vs 12 [11-13]; G4: 11 [10-13] vs 13 [12-14], all p < 0.01). The ability of both scores to identify patients at higher risk of in-hospital mortality, was similar in different age groups (4C-MS: G1 0.77, G2 0.76, G3 0.68, G4 0.72; COVID-19 MRS: G1 0.67, G2 0.69, G3 0.69, G4 0.72, all p for comparisons between subgroups = NS). Both scores confirmed their good performance in predicting in-hospital mortality in all age groups, despite their different mortality rate.
为了评估 4C 死亡率评分和 COVID-19 死亡率评分在不同年龄组中的预后分层能力。这是一项回顾性研究，纳入了 2020 年 2 月至 2021 年 5 月期间因 SARS-CoV2 入住卡雷吉大学医院急诊科并住院的所有患者。根据年龄分布的四分位将患者分为四个亚组：<57 岁（G1，n=546）、57-71 岁（G2，n=508）、72-81 岁（G3，n=552）和>82 岁（G4，n=578）。我们计算了 4C 死亡率评分和 COVID-19 死亡率评分。终点是院内死亡率。在整个人群（68±16 岁）中，死亡率为 19%（n=424），且随年龄增长而增加（G1：4%，G2：11%，G3：22%，G4：39%，p<0.001）。在所有亚组中，幸存者的死亡率均低于非幸存者（4C-MS，G1：6[3-7] vs 3[2-5]；G2：10[7-11] vs 7[5-8]；G3：11[10-14] vs 10[8-11]；G4：13[12-15] vs 11[10-13]，均 p<0.001；COVID-19 MRS，G1：8[7-9] vs 9[9-11]，G2：10[8-11] vs 11[10-12]；G3：11[10-12] vs 12[11-13]；G4：11[10-13] vs 13[12-14]，均 p<0.01）。这两个评分系统在不同年龄组中识别院内死亡风险较高的患者的能力相似（4C-MS：G1 为 0.77，G2 为 0.76，G3 为 0.68，G4 为 0.72；COVID-19 MRS：G1 为 0.67，G2 为 0.69，G3 为 0.69，G4 为 0.72，亚组间比较的所有 p 值均为 NS）。尽管死亡率不同，但这两个评分系统在所有年龄组中均能很好地预测院内死亡率。
