Utility of the 4C ISARIC mortality score in hospitalized COVID-19 patients at a large tertiary Saudi Arabian center.

IF 2 Q3 RESPIRATORY SYSTEM Multidisciplinary Respiratory Medicine Pub Date : 2023-01-17 DOI:10.4081/mrm.2023.917

Usama E Abu Elhassan, Saad M A Alqahtani, Naif S Al Saglan, Ali Hawan, Faisal S Alqahtani, Roaa S Almtheeb, Magda S R Abdelwahab, Mohammed A AlFlan, Abdulaziz S Y Alfaifi, Mohammed A Alqahtani, Fawwaz A Alshafa, Ali A Alsalem, Yahya A Al-Imamah, Omar S A Abdelwahab, Mohammed F Attia, Ibrahim M A Mahmoud

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Abstract

Background: The International Severe Acute Respiratory and Emerging Infections Consortium (ISARIC) 4C mortality score has been used before as a valuable tool for predicting mortality in COVID-19 patients. We aimed to address the utility of the 4C score in a well-defined Saudi population with COVID-19 admitted to a large tertiary referral hospital in Saudi Arabia.

Methods: A retrospective study was conducted that included all adults COVID‑19 patients admitted to the Armed Forces Hospital Southern Region (AFHSR), between January 2021 and September 2022. The receiver operating characteristic (ROC) curve depicted the diagnostic performance of the 4C Score for mortality prediction.

Results: A total of 1,853 patients were enrolled. The ROC curve of the 4C score had an area under the curve of 0.73 (95% CI: 0.702-0.758), p<0.001. The sensitivity and specificity with scores >8 were 80% and 58%, respectively, the positive and negative predictive values were 28% and 93%, respectively. Three hundred and sixteen (17.1%), 638 (34.4%), 814 (43.9%), and 85 (4.6%) patients had low, intermediate, high, and very high values, respectively. There were significant differences between survivors and non-survivors with regard to all variables used in the calculation of the 4C score. Multivariable logistic regression analysis revealed that all components of the 4C score, except gender and O₂ saturation, were independent significant predictors of mortality.

Conclusions: Our data support previous international and Saudi studies that the 4C mortality score is a reliable tool with good sensitivity and specificity in the mortality prediction of COVID-19 patients. All components of the 4C score, except gender and O₂ saturation, were independent significant predictors of mortality. Within the 4C score, odds ratios increased proportionately with an increase in the score value. Future multi-center prospective studies are warranted.

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4C ISARIC死亡率评分在沙特阿拉伯一家大型三级医疗中心住院的COVID-19患者中的应用

背景:国际严重急性呼吸道和新发感染联盟(ISARIC) 4C死亡率评分之前已被用作预测COVID-19患者死亡率的有价值工具。我们的目的是解决4C评分在沙特阿拉伯一家大型三级转诊医院入院的明确定义的沙特COVID-19患者中的效用。方法:对2021年1月至2022年9月期间在南部地区武装部队医院(AFHSR)住院的所有成年COVID - 19患者进行了回顾性研究。受试者工作特征(ROC)曲线描述4C评分对死亡率预测的诊断性能。结果:共纳入1853例患者。4C评分的ROC曲线下面积为0.73 (95% CI: 0.702 ~ 0.758)， p8分别为80%和58%，阳性预测值和阴性预测值分别为28%和93%。316例(17.1%)、638例(34.4%)、814例(43.9%)和85例(4.6%)患者分别为低值、中值、高值和极高值。在计算4C评分时使用的所有变量方面，幸存者和非幸存者之间存在显著差异。多变量logistic回归分析显示，除性别和氧饱和度外，4C评分的所有组成部分都是死亡率的独立显著预测因子。结论:我们的数据支持先前的国际和沙特研究，4C死亡率评分是预测COVID-19患者死亡率的可靠工具，具有良好的敏感性和特异性。除性别和氧饱和度外，4C评分的所有组成部分都是死亡率的独立显著预测因子。在4C评分范围内，优势比随着分值的增加成比例地增加。未来的多中心前瞻性研究是必要的。

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来源期刊

Multidisciplinary Respiratory Medicine 医学-呼吸系统

CiteScore

4.40

自引率

0.00%

发文量

审稿时长

>12 weeks

期刊介绍： Multidisciplinary Respiratory Medicine is the official journal of the Italian Respiratory Society - Società Italiana di Pneumologia (IRS/SIP). The journal publishes on all aspects of respiratory medicine and related fields, with a particular focus on interdisciplinary and translational research. The interdisciplinary nature of the journal provides a unique opportunity for researchers, clinicians and healthcare professionals across specialties to collaborate and exchange information. The journal provides a high visibility platform for the publication and dissemination of top quality original scientific articles, reviews and important position papers documenting clinical and experimental advances.