3 research outputs found
Predictors of mortality among hospitalized COVID-19 patients and risk score formulation for prioritizing tertiary careâAn experience from South India
BACKGROUND: We retrospectively data-mined the case records of Reverse Transcription Polymerase Chain Reaction (RT-PCR) confirmed COVID-19 patients hospitalized to a tertiary care centre to derive mortality predictors and formulate a risk score, for prioritizing admission. METHODS AND FINDINGS: Data on clinical manifestations, comorbidities, vital signs, and basic lab investigations collected as part of routine medical management at admission to a COVID-19 tertiary care centre in Chengalpattu, South India between May and November 2020 were retrospectively analysed to ascertain predictors of mortality in the univariate analysis using their relative difference in distribution among âsurvivorsâ and ânon-survivorsâ. The regression coefficients of those factors remaining significant in the multivariable logistic regression were utilised for risk score formulation and validated in 1000 bootstrap datasets. Among 746 COVID-19 patients hospitalised [487 âsurvivorsâ and 259 ânon-survivorsâ (deaths)], there was a slight male predilection [62.5%, (466/746)], with a higher mortality rate observed among 40â70 years age group [59.1%, (441/746)] and highest among diabetic patients with elevated urea levels [65.4% (68/104)]. The adjusted odds ratios of factors [OR (95% CI)] significant in the multivariable logistic regression were SaO(2)3; 3.01 (1.61â5.83), Age â„50 years;2.52 (1.45â4.43), Pulse Rate â„100/min: 2.02 (1.19â3.47) and coexisting Diabetes Mellitus; 1.73 (1.02â2.95) with hypertension and gender not retaining their significance. The individual risk scores for SaO(2)3â11, Age â„50 years-9, Pulse Rate â„100/min-7 and coexisting diabetes mellitus-6, acronymed collectively as âOUR-ARDs scoreâ showed that the sum of scores â„ 25 predicted mortality with a sensitivity-90%, specificity-64% and AUC of 0.85. CONCLUSIONS: The âOUR ARDsâ risk score, derived from easily assessable factors predicting mortality, offered a tangible solution for prioritizing admission to COVID-19 tertiary care centre, that enhanced patient care but without unduly straining the health system