Absolute mortality risk assessment of COVID-19 patients: the Khorshid COVID Cohort (KCC) study

BMC Medical Research Methodology

Shaghayegh Haghjooy Javanmard¹  Babak Amra²  Hamid Reza Marateb³  Miquel Angel Mañanas⁴  Marjan Mansourian⁵  Ramin Sami⁶  Martin Wolkewitz⁷  Maja von Cube⁷  Harald Binder⁷  Razieh Hassannejad⁸  Peyman Adibi⁹  Mojgan Mortazavi^1,10  Nilufar Khademi^1,11  Arash Toghyani^1,11  Nastaran Sadat Hosseini^1,11  Forogh Soltaninejad^1,12 

[1] Applied Physiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran;Bamdad Respiratory Research Center, Isfahan University of Medical Sciences, Isfahan, Iran;Biomedical Engineering Department, Engineering Faculty, University of Isfahan, Isfahan, Iran;Biomedical Engineering Research Centre (CREB), Automatic Control Department (ESAII), Universitat Politècnica de Catalunya-Barcelona Tech (UPC)Building H, Floor 4, Av. Diagonal 647, 08028, Barcelona, Spain;Biomedical Engineering Research Centre (CREB), Automatic Control Department (ESAII), Universitat Politècnica de Catalunya-Barcelona Tech (UPC)Building H, Floor 4, Av. Diagonal 647, 08028, Barcelona, Spain;Biomedical Research Networking Center in Bioengineering, Biomaterials, and Nanomedicine (CIBER-BBN), Madrid, Spain;Biomedical Engineering Research Centre (CREB), Automatic Control Department (ESAII), Universitat Politècnica de Catalunya-Barcelona Tech (UPC)Building H, Floor 4, Av. Diagonal 647, 08028, Barcelona, Spain;Department of Epidemiology and Biostatistics, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran;Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran;Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany;Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran;Isfahan Gastroenterology and Hepatology Research Center (lGHRC), Isfahan University of Medical Sciences, Isfahan, Iran;Isfahan Kidney Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran;School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran;The Respiratory Research Center, Pulmonary Division, Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran;

关键词: Cause-specific hazard regression;    COVID-19;    Mortality;    Prognosis;    Risk assessment;    Risk chart;   

DOI  :  10.1186/s12874-021-01340-8

来源: Springer

【 摘 要 】

BackgroundAlready at hospital admission, clinicians require simple tools to identify hospitalized COVID-19 patients at high risk of mortality. Such tools can significantly improve resource allocation and patient management within hospitals. From the statistical point of view, extended time-to-event models are required to account for competing risks (discharge from hospital) and censoring so that active cases can also contribute to the analysis.MethodsWe used the hospital-based open Khorshid COVID Cohort (KCC) study with 630 COVID-19 patients from Isfahan, Iran. Competing risk methods are used to develop a death risk chart based on the following variables, which can simply be measured at hospital admission: sex, age, hypertension, oxygen saturation, and Charlson Comorbidity Index. The area under the receiver operator curve was used to assess accuracy concerning discrimination between patients discharged alive and dead.ResultsCause-specific hazard regression models show that these baseline variables are associated with both death, and discharge hazards. The risk chart reflects the combined results of the two cause-specific hazard regression models. The proposed risk assessment method had a very good accuracy (AUC = 0.872 [CI 95%: 0.835–0.910]).ConclusionsThis study aims to improve and validate a personalized mortality risk calculator based on hospitalized COVID-19 patients. The risk assessment of patient mortality provides physicians with additional guidance for making tough decisions.

【 授权许可】

CC BY