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10.1111/jgs.16956

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33197278!7753731!33197278
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suck abstract from ncbi


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pmid33197278      J+Am+Geriatr+Soc 2021 ; 69 (1): 37-43
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  • Predicting In-Hospital Mortality in COVID-19 Older Patients with Specifically Developed Scores #MMPMID33197278
  • Covino M; De Matteis G; Burzo ML; Russo A; Forte E; Carnicelli A; Piccioni A; Simeoni B; Gasbarrini A; Franceschi F; Sandroni C
  • J Am Geriatr Soc 2021[Jan]; 69 (1): 37-43 PMID33197278show ga
  • BACKGROUND/OBJECTIVES: Several scoring systems have been specifically developed for risk stratification in COVID-19 patients. DESIGN: We compared, in a cohort of confirmed COVID-19 older patients, three specifically developed scores with a previously established early warning score. Main endpoint was all causes in-hospital death. SETTING: This is a single-center, retrospective observational study, conducted in the Emergency Department (ED) of an urban teaching hospital, referral center for COVID-19. PARTICIPANTS: We reviewed the clinical records of the confirmed COVID-19 patients aged 60 years or more consecutively admitted to our ED over a 6-week period (March 1st to April 15th, 2020). A total of 210 patients, aged between 60 and 98 years were included in the study cohort. MEASUREMENTS: International Severe Acute Respiratory Infection Consortium Clinical Characterization Protocol-Coronavirus Clinical Characterization Consortium (ISARIC-4C) score, COVID-GRAM Critical Illness Risk Score (COVID-GRAM), quick COVID-19 Severity Index (qCSI), National Early Warning Score (NEWS). RESULTS: Median age was 74 (67-82) and 133 (63.3%) were males. Globally, 42 patients (20.0%) deceased. All the score evaluated showed a fairly good predictive value with respect to in-hospital death. The ISARIC-4C score had the highest area under ROC curve (AUROC) 0.799 (0.738-0.851), followed by the COVID-GRAM 0.785 (0.723-0.838), NEWS 0.764 (0.700-0.819), and qCSI 0.749 (0.685-0.806). However, these differences were not statistical significant. CONCLUSION: Among the evaluated scores, the ISARIC-4C and the COVID-GRAM, calculated at ED admission, had the best performance, although the qCSI had similar efficacy by evaluating only three items. However, the NEWS, already widely validated in clinical practice, had a similar performance and could be appropriate for older patients with COVID-19.
  • |*Hospital Mortality[MESH]
  • |*Severity of Illness Index[MESH]
  • |Aged[MESH]
  • |COVID-19/*mortality/therapy[MESH]
  • |Cohort Studies[MESH]
  • |Critical Illness/*mortality/therapy[MESH]
  • |Emergency Service, Hospital[MESH]
  • |Female[MESH]
  • |Humans[MESH]
  • |Italy[MESH]
  • |Male[MESH]
  • |Middle Aged[MESH]


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