4C mortality score and COVID-19 mortality risk score: an analysis in four different age groups of an Italian population.
COVID-19
Critical care
Emergency care systems
Prognostic scores
Journal
Internal and emergency medicine
ISSN: 1970-9366
Titre abrégé: Intern Emerg Med
Pays: Italy
ID NLM: 101263418
Informations de publication
Date de publication:
23 Feb 2024
23 Feb 2024
Historique:
received:
30
11
2023
accepted:
18
01
2024
medline:
23
2
2024
pubmed:
23
2
2024
entrez:
23
2
2024
Statut:
aheadofprint
Résumé
To evaluate the prognostic stratification ability of 4C Mortality Score and COVID-19 Mortality Risk Score in different age groups. Retrospective study, including all patients, presented to the Emergency Department of the University Hospital Careggi, between February, 2020 and May, 2021, and admitted for SARS-CoV2. Patients were divided into four subgroups based on the quartiles of age distribution: patients < 57 years (G1, n = 546), 57-71 years (G2, n = 508), 72-81 years (G3, n = 552), and > 82 years (G4, n = 578). We calculated the 4C Mortality Score and COVID-19 Mortality Risk Score. The end-point was in-hospital mortality. In the whole population (age 68 ± 16 years), the mortality rate was 19% (n = 424), and increased with increasing age (G1: 4%, G2: 11%, G3: 22%, and G4: 39%, p < 0.001). Both scores were higher among non-survivors than survivors in all subgroups (4C-MS, G1: 6 [3-7] vs 3 [2-5]; G2: 10 [7-11] vs 7 [5-8]; G3: 11 [10-14] vs 10 [8-11]; G4: 13 [12-15] vs 11 [10-13], all p < 0.001; COVID-19 MRS, G1: 8 [7-9] vs 9 [9-11], G2: 10 [8-11] vs 11 [10-12]; G3: 11 [10-12] vs 12 [11-13]; G4: 11 [10-13] vs 13 [12-14], all p < 0.01). The ability of both scores to identify patients at higher risk of in-hospital mortality, was similar in different age groups (4C-MS: G1 0.77, G2 0.76, G3 0.68, G4 0.72; COVID-19 MRS: G1 0.67, G2 0.69, G3 0.69, G4 0.72, all p for comparisons between subgroups = NS). Both scores confirmed their good performance in predicting in-hospital mortality in all age groups, despite their different mortality rate.
Identifiants
pubmed: 38393501
doi: 10.1007/s11739-024-03551-5
pii: 10.1007/s11739-024-03551-5
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2024. The Author(s), under exclusive licence to Società Italiana di Medicina Interna (SIMI).
Références
Rahman S, Montero MTV, Rowe K, Kirton R, Kunik F Jr (2021) Epidemiology, pathogenesis, clinical presentations, diagnosis and treatment of COVID-19: a review of current evidence. Expert Rev Clin Pharmacol 14(5):601–621. https://doi.org/10.1080/17512433.2021.1902303
doi: 10.1080/17512433.2021.1902303
pubmed: 33705239
Lynch SM, Guo G, Gibson DS, Bjourson AJ, Rai TS (2021) Role of senescence and aging in SARS-CoV-2 infection and COVID-19 disease. Cells. https://doi.org/10.3390/cells10123367
doi: 10.3390/cells10123367
pubmed: 34943875
pmcid: 8699414
Becerra-Munoz VM, Nunez-Gil IJ, Eid CM, Garcia Aguado M, Romero R, Huang J et al (2021) Clinical profile and predictors of in-hospital mortality among older patients hospitalised for COVID-19. Age Ageing 50(2):326–334. https://doi.org/10.1093/ageing/afaa258
doi: 10.1093/ageing/afaa258
pubmed: 33201181
Lim WS, van der Eerden MM, Laing R, Boersma WG, Karalus N, Town GI et al (2003) Defining community acquired pneumonia severity on presentation to hospital: an international derivation and validation study. Thorax 58(5):377–382. https://doi.org/10.1136/thorax.58.5.377
doi: 10.1136/thorax.58.5.377
pubmed: 12728155
pmcid: 1746657
Guo L, Wei D, Zhang X, Wu Y, Li Q, Zhou M et al (2019) Clinical features predicting mortality risk in patients with viral pneumonia: the MuLBSTA score. Front Microbiol 10:2752. https://doi.org/10.3389/fmicb.2019.02752
doi: 10.3389/fmicb.2019.02752
pubmed: 31849894
pmcid: 6901688
Knight SR, Ho A, Pius R, Buchan I, Carson G, Drake TM et al (2020) Risk stratification of patients admitted to hospital with covid-19 using the ISARIC WHO Clinical Characterisation Protocol: development and validation of the 4C Mortality Score. BMJ 370:m3339. https://doi.org/10.1136/bmj.m3339
doi: 10.1136/bmj.m3339
pubmed: 32907855
Dong Y, Zhou H, Li M, Zhang Z, Guo W, Yu T et al (2020) A novel simple scoring model for predicting severity of patients with SARS-CoV-2 infection. Transbound Emerg Dis 67(6):2823–2829. https://doi.org/10.1111/tbed.13651
doi: 10.1111/tbed.13651
pubmed: 32469137
pmcid: 7283685
Innocenti F, De Paris A, Lagomarsini A, Pelagatti L, Casalini L, Gianno A et al (2022) Stratification of patients admitted for SARS-CoV2 infection: prognostic scores in the first and second wave of the pandemic. Intern Emerg Med 17(7):2093–2101. https://doi.org/10.1007/s11739-022-03016-7
doi: 10.1007/s11739-022-03016-7
pubmed: 35733074
pmcid: 9216296
Fumagalli C, Rozzini R, Vannini M, Coccia F, Cesaroni G, Mazzeo F et al (2020) Clinical risk score to predict in-hospital mortality in COVID-19 patients: a retrospective cohort study. BMJ Open 10(9):e040729. https://doi.org/10.1136/bmjopen-2020-040729
doi: 10.1136/bmjopen-2020-040729
pubmed: 32978207
Fumagalli C, Ungar A, Rozzini R, Vannini M, Coccia F, Cesaroni G et al (2021) Predicting mortality risk in older hospitalized persons with COVID-19: a comparison of the COVID-19 mortality risk score with frailty and disability. J Am Med Dir Assoc 22(8):1588–1592. https://doi.org/10.1016/j.jamda.2021.05.028
doi: 10.1016/j.jamda.2021.05.028
pubmed: 34334160
pmcid: 8249822
Aletreby WT, Mumtaz SA, Shahzad SA, Ahmed I, Alodat MA, Gharba M et al (2022) External validation of 4C ISARIC mortality score in critically ill COVID-19 patients from Saudi Arabia. Saudi J Med Med Sci 10(1):19–24. https://doi.org/10.4103/sjmms.sjmms_480_21
doi: 10.4103/sjmms.sjmms_480_21
pubmed: 35283713
pmcid: 8869262
Vallipuram T, Schwartz BC, Yang SS, Jayaraman D, Dial S (2023) External validation of the ISARIC 4C Mortality Score to predict in-hospital mortality among patients with COVID-19 in a Canadian intensive care unit: a single-centre historical cohort study. Can J Anaesth 70(8):1362–1370. https://doi.org/10.1007/s12630-023-02512-4
doi: 10.1007/s12630-023-02512-4
pubmed: 37286748
Yang S, Zhang Y, He Y, Liu S (2023) Comparison of prognostic scores for patients with COVID-19 presenting with dyspnea in the emergency department. J Emerg Med 65(6):e487–e494. https://doi.org/10.1016/j.jemermed.2023.07.013
doi: 10.1016/j.jemermed.2023.07.013
pubmed: 37838495
Cunha LL, Perazzio SF, Azzi J, Cravedi P, Riella LV (2020) Remodeling of the immune response with aging: immunosenescence and its potential impact on COVID-19 immune response. Front Immunol 11:1748. https://doi.org/10.3389/fimmu.2020.01748
doi: 10.3389/fimmu.2020.01748
pubmed: 32849623
pmcid: 7427491
Meftahi GH, Jangravi Z, Sahraei H, Bahari Z (2020) The possible pathophysiology mechanism of cytokine storm in elderly adults with COVID-19 infection: the contribution of “inflame-aging.” Inflamm Res 69(9):825–839. https://doi.org/10.1007/s00011-020-01372-8
doi: 10.1007/s00011-020-01372-8
pubmed: 32529477
pmcid: 7289226
Xu KQ, Wei YQ, Giunta S, Zhou M, Xia SJ (2021) Do inflammaging and coagul-aging play a role as conditions contributing to the co-occurrence of the severe hyper-inflammatory state and deadly coagulopathy during COVID-19 in older people? Exp Gerontol. https://doi.org/10.1016/j.exger.2021.111423
doi: 10.1016/j.exger.2021.111423
pubmed: 34560198
pmcid: 8149167