Validation of extracorporeal membrane oxygenation mortality prediction and severity of illness scores in an international COVID-19 cohort
© 2023 International Center for Artificial Organ and Transplantation (ICAOT) and Wiley Periodicals LLC..
BACKGROUND: Veno-venous extracorporeal membrane oxygenation (V-V ECMO) is a lifesaving support modality for severe respiratory failure, but its resource-intensive nature led to significant controversy surrounding its use during the COVID-19 pandemic. We report the performance of several ECMO mortality prediction and severity of illness scores at discriminating survival in a large COVID-19 V-V ECMO cohort.
METHODS: We validated ECMOnet, PRESET (PREdiction of Survival on ECMO Therapy-Score), Roch, SOFA (Sequential Organ Failure Assessment), APACHE II (acute physiology and chronic health evaluation), 4C (Coronavirus Clinical Characterisation Consortium), and CURB-65 (Confusion, Urea nitrogen, Respiratory Rate, Blood Pressure, age >65 years) scores on the ISARIC (International Severe Acute Respiratory and emerging Infection Consortium) database. We report discrimination via Area Under the Receiver Operative Curve (AUROC) and Area under the Precision Recall Curve (AURPC) and calibration via Brier score.
RESULTS: We included 1147 patients and scores were calculated on patients with sufficient variables. ECMO mortality scores had AUROC (0.58-0.62), AUPRC (0.62-0.74), and Brier score (0.286-0.303). Roch score had the highest accuracy (AUROC 0.62), precision (AUPRC 0.74) yet worst calibration (Brier score of 0.3) despite being calculated on the fewest patients (144). Severity of illness scores had AUROC (0.52-0.57), AURPC (0.59-0.64), and Brier Score (0.265-0.471). APACHE II had the highest accuracy (AUROC 0.58), precision (AUPRC 0.64), and best calibration (Brier score 0.26).
CONCLUSION: Within a large international multicenter COVID-19 cohort, the evaluated ECMO mortality prediction and severity of illness scores demonstrated inconsistent discrimination and calibration highlighting the need for better clinically applicable decision support tools.
Medienart: |
E-Artikel |
---|
Erscheinungsjahr: |
2023 |
---|---|
Erschienen: |
2023 |
Enthalten in: |
Zur Gesamtaufnahme - volume:47 |
---|---|
Enthalten in: |
Artificial organs - 47(2023), 9 vom: 05. Sept., Seite 1490-1502 |
Sprache: |
Englisch |
---|
Beteiligte Personen: |
Shah, Neel [VerfasserIn] |
---|
Links: |
---|
Themen: |
ARDS |
---|
Anmerkungen: |
Date Completed 28.09.2023 Date Revised 20.03.2024 published: Print-Electronic Citation Status MEDLINE |
---|
doi: |
10.1111/aor.14542 |
---|
funding: |
|
---|---|
Förderinstitution / Projekttitel: |
|
PPN (Katalog-ID): |
NLM355371960 |
---|
LEADER | 01000caa a22002652 4500 | ||
---|---|---|---|
001 | NLM355371960 | ||
003 | DE-627 | ||
005 | 20240320233049.0 | ||
007 | cr uuu---uuuuu | ||
008 | 231226s2023 xx |||||o 00| ||eng c | ||
024 | 7 | |a 10.1111/aor.14542 |2 doi | |
028 | 5 | 2 | |a pubmed24n1337.xml |
035 | |a (DE-627)NLM355371960 | ||
035 | |a (NLM)37032544 | ||
040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
041 | |a eng | ||
100 | 1 | |a Shah, Neel |e verfasserin |4 aut | |
245 | 1 | 0 | |a Validation of extracorporeal membrane oxygenation mortality prediction and severity of illness scores in an international COVID-19 cohort |
264 | 1 | |c 2023 | |
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 28.09.2023 | ||
500 | |a Date Revised 20.03.2024 | ||
500 | |a published: Print-Electronic | ||
500 | |a Citation Status MEDLINE | ||
520 | |a © 2023 International Center for Artificial Organ and Transplantation (ICAOT) and Wiley Periodicals LLC. | ||
520 | |a BACKGROUND: Veno-venous extracorporeal membrane oxygenation (V-V ECMO) is a lifesaving support modality for severe respiratory failure, but its resource-intensive nature led to significant controversy surrounding its use during the COVID-19 pandemic. We report the performance of several ECMO mortality prediction and severity of illness scores at discriminating survival in a large COVID-19 V-V ECMO cohort | ||
520 | |a METHODS: We validated ECMOnet, PRESET (PREdiction of Survival on ECMO Therapy-Score), Roch, SOFA (Sequential Organ Failure Assessment), APACHE II (acute physiology and chronic health evaluation), 4C (Coronavirus Clinical Characterisation Consortium), and CURB-65 (Confusion, Urea nitrogen, Respiratory Rate, Blood Pressure, age >65 years) scores on the ISARIC (International Severe Acute Respiratory and emerging Infection Consortium) database. We report discrimination via Area Under the Receiver Operative Curve (AUROC) and Area under the Precision Recall Curve (AURPC) and calibration via Brier score | ||
520 | |a RESULTS: We included 1147 patients and scores were calculated on patients with sufficient variables. ECMO mortality scores had AUROC (0.58-0.62), AUPRC (0.62-0.74), and Brier score (0.286-0.303). Roch score had the highest accuracy (AUROC 0.62), precision (AUPRC 0.74) yet worst calibration (Brier score of 0.3) despite being calculated on the fewest patients (144). Severity of illness scores had AUROC (0.52-0.57), AURPC (0.59-0.64), and Brier Score (0.265-0.471). APACHE II had the highest accuracy (AUROC 0.58), precision (AUPRC 0.64), and best calibration (Brier score 0.26) | ||
520 | |a CONCLUSION: Within a large international multicenter COVID-19 cohort, the evaluated ECMO mortality prediction and severity of illness scores demonstrated inconsistent discrimination and calibration highlighting the need for better clinically applicable decision support tools | ||
650 | 4 | |a Multicenter Study | |
650 | 4 | |a Journal Article | |
650 | 4 | |a ARDS | |
650 | 4 | |a COVID-19 | |
650 | 4 | |a ECLS | |
650 | 4 | |a Sars-Cov2 | |
650 | 4 | |a V-V ECMO | |
650 | 4 | |a extracorporeal life support | |
650 | 4 | |a extracorporeal membrane oxygenation | |
650 | 4 | |a mortality | |
650 | 4 | |a prediction scores | |
700 | 1 | |a Xue, Bing |e verfasserin |4 aut | |
700 | 1 | |a Xu, Ziqi |e verfasserin |4 aut | |
700 | 1 | |a Yang, Hanqing |e verfasserin |4 aut | |
700 | 1 | |a Marwali, Eva |e verfasserin |4 aut | |
700 | 1 | |a Dalton, Heidi |e verfasserin |4 aut | |
700 | 1 | |a Payne, Philip P R |e verfasserin |4 aut | |
700 | 1 | |a Lu, Chenyang |e verfasserin |4 aut | |
700 | 1 | |a Said, Ahmed S |e verfasserin |4 aut | |
700 | 0 | |a ISARIC Clinical Characterisation Group |e verfasserin |4 aut | |
700 | 1 | |a Abdukahil, Sheryl Ann |e investigator |4 oth | |
700 | 1 | |a Abdulkadir, Nurul Najmee |e investigator |4 oth | |
700 | 1 | |a Absil, Lara |e investigator |4 oth | |
700 | 1 | |a Acker, Andrew |e investigator |4 oth | |
700 | 1 | |a Adrião, Diana |e investigator |4 oth | |
700 | 1 | |a Hssain, Ali Ait |e investigator |4 oth | |
700 | 1 | |a Akwani, Chika |e investigator |4 oth | |
700 | 1 | |a Al Qasim, Eman |e investigator |4 oth | |
700 | 1 | |a Alalqam, Razi |e investigator |4 oth | |
700 | 1 | |a Al-Dabbous, Tala |e investigator |4 oth | |
700 | 1 | |a Alex, Beatrice |e investigator |4 oth | |
700 | 1 | |a Al-Fares, Abdulrahman |e investigator |4 oth | |
700 | 1 | |a Alfoudri, Huda |e investigator |4 oth | |
700 | 1 | |a Aliudin, Jeffrey |e investigator |4 oth | |
700 | 1 | |a Alves, João |e investigator |4 oth | |
700 | 1 | |a Alves, Rita |e investigator |4 oth | |
700 | 1 | |a Alves, João Melo |e investigator |4 oth | |
700 | 1 | |a Cabrita, Joana Alves |e investigator |4 oth | |
700 | 1 | |a Amaral, Maria |e investigator |4 oth | |
700 | 1 | |a Amira, Nur |e investigator |4 oth | |
700 | 1 | |a Andini, Roberto |e investigator |4 oth | |
700 | 1 | |a Anthonidass, Sivanesen |e investigator |4 oth | |
700 | 1 | |a Antonelli, Massimo |e investigator |4 oth | |
700 | 1 | |a Arabi, Yaseen |e investigator |4 oth | |
700 | 1 | |a Arcadipane, Antonio |e investigator |4 oth | |
700 | 1 | |a Arenz, Lukas |e investigator |4 oth | |
700 | 1 | |a Arnold-Day, Christel |e investigator |4 oth | |
700 | 1 | |a Arora, Lovkesh |e investigator |4 oth | |
700 | 1 | |a Arora, Rakesh |e investigator |4 oth | |
700 | 1 | |a Ashraf, Muhammad |e investigator |4 oth | |
700 | 1 | |a Asyraf, Amirul |e investigator |4 oth | |
700 | 1 | |a Atique, Anika |e investigator |4 oth | |
700 | 1 | |a Bach, Benjamin |e investigator |4 oth | |
700 | 1 | |a Baillie, John Kenneth |e investigator |4 oth | |
700 | 1 | |a Bak, Erica |e investigator |4 oth | |
700 | 1 | |a Bakar, Nazreen Abu |e investigator |4 oth | |
700 | 1 | |a Balakrishnan, Mohanaprasanth |e investigator |4 oth | |
700 | 1 | |a Barbalho, Renata |e investigator |4 oth | |
700 | 1 | |a Barclay, Wendy S |e investigator |4 oth | |
700 | 1 | |a Barnett, Saef Umar |e investigator |4 oth | |
700 | 1 | |a Barnikel, Michaela |e investigator |4 oth | |
700 | 1 | |a Barrasa, Helena |e investigator |4 oth | |
700 | 1 | |a Barrigoto, Cleide |e investigator |4 oth | |
700 | 1 | |a Baruch, Joaquín |e investigator |4 oth | |
700 | 1 | |a Basri, Muhammad Fadhli Hassin |e investigator |4 oth | |
700 | 1 | |a Battaglini, Denise |e investigator |4 oth | |
700 | 1 | |a Rincon, Diego Fernando Bautista |e investigator |4 oth | |
700 | 1 | |a Bee, Ker Hong |e investigator |4 oth | |
700 | 1 | |a Begum, Husna |e investigator |4 oth | |
700 | 1 | |a Beljantsev, Aleksandr |e investigator |4 oth | |
700 | 1 | |a Benjiman, Lionel Eric |e investigator |4 oth | |
700 | 1 | |a Bento, Luís |e investigator |4 oth | |
700 | 1 | |a Sobrino, José Luis Bernal |e investigator |4 oth | |
700 | 1 | |a Bertolino, Lorenzo |e investigator |4 oth | |
700 | 1 | |a Bhatt, Amar |e investigator |4 oth | |
700 | 1 | |a Bianco, Claudia |e investigator |4 oth | |
700 | 1 | |a Bidin, Farah Nadiah |e investigator |4 oth | |
700 | 1 | |a Humaid, Felwa Bin |e investigator |4 oth | |
700 | 1 | |a Kamarudin, Mohd Nazlin Bin |e investigator |4 oth | |
700 | 1 | |a Blanco-Schweizer, Pablo |e investigator |4 oth | |
700 | 1 | |a Bloos, Frank |e investigator |4 oth | |
700 | 1 | |a Boccia, Filomena |e investigator |4 oth | |
700 | 1 | |a Bogaert, Debby |e investigator |4 oth | |
700 | 1 | |a Borges, Diogo |e investigator |4 oth | |
700 | 1 | |a Bouhmani, Dounia |e investigator |4 oth | |
700 | 1 | |a Bouziotis, Jason |e investigator |4 oth | |
700 | 1 | |a Boylan, Maria |e investigator |4 oth | |
700 | 1 | |a Bozza, Fernando Augusto |e investigator |4 oth | |
700 | 1 | |a Brazzi, Luca |e investigator |4 oth | |
700 | 1 | |a Brewster, David |e investigator |4 oth | |
700 | 1 | |a Brickell, Kathy |e investigator |4 oth | |
700 | 1 | |a Broadley, Tessa |e investigator |4 oth | |
700 | 1 | |a Brozzi, Nicolas |e investigator |4 oth | |
700 | 1 | |a Buchtele, Nina |e investigator |4 oth | |
700 | 1 | |a Burrell, Aidan |e investigator |4 oth | |
700 | 1 | |a Cabral, Susana |e investigator |4 oth | |
700 | 1 | |a Cabrita, Joana |e investigator |4 oth | |
700 | 1 | |a Garcês, Rui Caetano |e investigator |4 oth | |
700 | 1 | |a Calligy, Kate |e investigator |4 oth | |
700 | 1 | |a Campbell, Paul |e investigator |4 oth | |
700 | 1 | |a Cardoso, Sofia |e investigator |4 oth | |
700 | 1 | |a Cardoso, Filipe |e investigator |4 oth | |
700 | 1 | |a Cardoso, Filipa |e investigator |4 oth | |
700 | 1 | |a Carelli, Simone |e investigator |4 oth | |
700 | 1 | |a Carrier, François Martin |e investigator |4 oth | |
700 | 1 | |a Carson, Gail |e investigator |4 oth | |
700 | 1 | |a Cascão, Mariana |e investigator |4 oth | |
700 | 1 | |a Casimiro, José |e investigator |4 oth | |
700 | 1 | |a Castanheira, Nidyanara |e investigator |4 oth | |
700 | 1 | |a Castro, Ivo |e investigator |4 oth | |
700 | 1 | |a Catarino, Ana |e investigator |4 oth | |
700 | 1 | |a Cavalin, Roberta |e investigator |4 oth | |
700 | 1 | |a Cavalli, Giulio Giovanni |e investigator |4 oth | |
700 | 1 | |a Cavayas, Alexandros |e investigator |4 oth | |
700 | 1 | |a Chand, Meera |e investigator |4 oth | |
700 | 1 | |a Chen, Anjellica |e investigator |4 oth | |
700 | 1 | |a Chen, Yih-Sharng |e investigator |4 oth | |
700 | 1 | |a Cheng, Matthew Pellan |e investigator |4 oth | |
700 | 1 | |a Chica, Julian |e investigator |4 oth | |
700 | 1 | |a Chidambaram, Suresh Kumar |e investigator |4 oth | |
773 | 0 | 8 | |i Enthalten in |t Artificial organs |d 1992 |g 47(2023), 9 vom: 05. Sept., Seite 1490-1502 |w (DE-627)NLM000347590 |x 1525-1594 |7 nnns |
773 | 1 | 8 | |g volume:47 |g year:2023 |g number:9 |g day:05 |g month:09 |g pages:1490-1502 |
856 | 4 | 0 | |u http://dx.doi.org/10.1111/aor.14542 |3 Volltext |
912 | |a GBV_USEFLAG_A | ||
912 | |a GBV_NLM | ||
951 | |a AR | ||
952 | |d 47 |j 2023 |e 9 |b 05 |c 09 |h 1490-1502 |