External validation of the COVID-19 4C mortality score in an urban United States cohort
Copyright © 2022 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved..
BACKGROUND: Identifying patients at risk for mortality from COVID-19 is crucial to triage, clinical decision-making, and the allocation of scarce hospital resources. The 4C Mortality Score effectively predicts COVID-19 mortality, but it has not been validated in a United States (U.S.) population. The purpose of this study is to determine whether the 4C Mortality Score accurately predicts COVID-19 mortality in an urban U.S. adult inpatient population.
METHODS: This retrospective cohort study included adult patients admitted to a single-center, tertiary care hospital (Philadelphia, PA) with a positive SARS-CoV-2 PCR from 3/01/2020 to 6/06/2020. Variables were extracted through a combination of automated export and manual chart review. The outcome of interest was mortality during hospital admission or within 30 days of discharge.
RESULTS: This study included 426 patients; mean age was 64.4 years, 43.4% were female, and 54.5% self-identified as Black or African American. All-cause mortality was observed in 71 patients (16.7%). The area under the receiver operator characteristic curve of the 4C Mortality Score was 0.85 (95% confidence interval, 0.79-0.89).
CONCLUSIONS: Clinicians may use the 4C Mortality Score in an urban, majority Black, U.S. inpatient population. The derivation and validation cohorts were treated in the pre-vaccine era so the 4C Score may over-predict mortality in current patient populations. With stubbornly high inpatient mortality rates, however, the 4C Score remains one of the best tools available to date to inform thoughtful triage and treatment allocation.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2022 |
|---|---|
| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:364 |
|---|---|
| Enthalten in: |
The American journal of the medical sciences - 364(2022), 4 vom: 15. Okt., Seite 409-413 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Riley, Joshua M [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
|---|
| Anmerkungen: |
Date Completed 28.09.2022 Date Revised 24.01.2023 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1016/j.amjms.2022.04.030 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM340294248 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM340294248 | ||
| 003 | DE-627 | ||
| 005 | 20231226004821.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2022 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1016/j.amjms.2022.04.030 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1134.xml |
| 035 | |a (DE-627)NLM340294248 | ||
| 035 | |a (NLM)35500663 | ||
| 035 | |a (PII)S0002-9629(22)00211-7 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Riley, Joshua M |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a External validation of the COVID-19 4C mortality score in an urban United States cohort |
| 264 | 1 | |c 2022 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 28.09.2022 | ||
| 500 | |a Date Revised 24.01.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2022 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved. | ||
| 520 | |a BACKGROUND: Identifying patients at risk for mortality from COVID-19 is crucial to triage, clinical decision-making, and the allocation of scarce hospital resources. The 4C Mortality Score effectively predicts COVID-19 mortality, but it has not been validated in a United States (U.S.) population. The purpose of this study is to determine whether the 4C Mortality Score accurately predicts COVID-19 mortality in an urban U.S. adult inpatient population | ||
| 520 | |a METHODS: This retrospective cohort study included adult patients admitted to a single-center, tertiary care hospital (Philadelphia, PA) with a positive SARS-CoV-2 PCR from 3/01/2020 to 6/06/2020. Variables were extracted through a combination of automated export and manual chart review. The outcome of interest was mortality during hospital admission or within 30 days of discharge | ||
| 520 | |a RESULTS: This study included 426 patients; mean age was 64.4 years, 43.4% were female, and 54.5% self-identified as Black or African American. All-cause mortality was observed in 71 patients (16.7%). The area under the receiver operator characteristic curve of the 4C Mortality Score was 0.85 (95% confidence interval, 0.79-0.89) | ||
| 520 | |a CONCLUSIONS: Clinicians may use the 4C Mortality Score in an urban, majority Black, U.S. inpatient population. The derivation and validation cohorts were treated in the pre-vaccine era so the 4C Score may over-predict mortality in current patient populations. With stubbornly high inpatient mortality rates, however, the 4C Score remains one of the best tools available to date to inform thoughtful triage and treatment allocation | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a COVID-19 | |
| 650 | 4 | |a Evidence-based medicine | |
| 650 | 4 | |a Risk | |
| 650 | 4 | |a Triage | |
| 700 | 1 | |a Moeller, Patrick J |e verfasserin |4 aut | |
| 700 | 1 | |a Crawford, Albert G |e verfasserin |4 aut | |
| 700 | 1 | |a Schaefer, Joseph W |e verfasserin |4 aut | |
| 700 | 1 | |a Cheney-Peters, Dianna R |e verfasserin |4 aut | |
| 700 | 1 | |a Venkataraman, Chantel M |e verfasserin |4 aut | |
| 700 | 1 | |a Li, Chris J |e verfasserin |4 aut | |
| 700 | 1 | |a Smaltz, Christa M |e verfasserin |4 aut | |
| 700 | 1 | |a Bradley, Conor G |e verfasserin |4 aut | |
| 700 | 1 | |a Lee, Crystal Y |e verfasserin |4 aut | |
| 700 | 1 | |a Fitzpatrick, Danielle M |e verfasserin |4 aut | |
| 700 | 1 | |a Ney, David B |e verfasserin |4 aut | |
| 700 | 1 | |a Zaret, Dina S |e verfasserin |4 aut | |
| 700 | 1 | |a Chalikonda, Divya M |e verfasserin |4 aut | |
| 700 | 1 | |a Mairose, Joshua D |e verfasserin |4 aut | |
| 700 | 1 | |a Chauhan, Kashyap |e verfasserin |4 aut | |
| 700 | 1 | |a Szot, Margaret V |e verfasserin |4 aut | |
| 700 | 1 | |a Jones, Robert B |e verfasserin |4 aut | |
| 700 | 1 | |a Bashir-Hamidu, Rukaiya |e verfasserin |4 aut | |
| 700 | 1 | |a Mitsuhashi, Shuji |e verfasserin |4 aut | |
| 700 | 1 | |a Kubey, Alan A |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t The American journal of the medical sciences |d 1945 |g 364(2022), 4 vom: 15. Okt., Seite 409-413 |w (DE-627)NLM000046051 |x 1538-2990 |7 nnns |
| 773 | 1 | 8 | |g volume:364 |g year:2022 |g number:4 |g day:15 |g month:10 |g pages:409-413 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1016/j.amjms.2022.04.030 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 364 |j 2022 |e 4 |b 15 |c 10 |h 409-413 | ||