Establishment of Routine Clinical Indicators-Based Nomograms for Predicting the Mortality in Patients With COVID-19

Frontiers in Medicine

Hui Lin¹  En Liu¹  Yuliang Liu²  Ping Li³  XiaoBao Ren⁴  Yongfeng Tian⁵  Jialin He⁶  Xi Liu⁶  Shiming Yang⁶  Cheng Zhang⁷  Wei Duan⁸  Yu Xu⁹  Mingdong Hu⁹  Wenjing Zhang⁹  Qi Li⁹  Caiping Song^1,10  Zhi Xu^1,11  Hao Wu^1,12 

[1] Department of Gastroenterology, Xinqiao Hospital, The Army Medical University, Chongqing, China;Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China;Huo-Shen-Shan Hospital, Wuhan, China;Jin Yin-tan Hospital, The Medical Team of the Army Medical University, Wuhan, China;Department of Cardiology, Xinqiao Hospital, The Army Medical University, Chongqing, China;Huo-Shen-Shan Hospital, Wuhan, China;Jin Yin-tan Hospital, The Medical Team of the Army Medical University, Wuhan, China;Department of Emergency, Xinan Hospital, The Army Medical University, Chongqing, China;Huo-Shen-Shan Hospital, Wuhan, China;Jin Yin-tan Hospital, The Medical Team of the Army Medical University, Wuhan, China;Department of Endocrinology, Xinqiao Hospital, The Army Medical University, Chongqing, China;Huo-Shen-Shan Hospital, Wuhan, China;Jin Yin-tan Hospital, The Medical Team of the Army Medical University, Wuhan, China;Department of Gastroenterology, Xinqiao Hospital, The Army Medical University, Chongqing, China;Huo-Shen-Shan Hospital, Wuhan, China;Jin Yin-tan Hospital, The Medical Team of the Army Medical University, Wuhan, China;Department of Hematology, Xinqiao Hospital, The Army Medical University, Chongqing, China;Huo-Shen-Shan Hospital, Wuhan, China;Jin Yin-tan Hospital, The Medical Team of the Army Medical University, Wuhan, China;Department of Neurology, Xinqiao Hospital, The Army Medical University, Chongqing, China;Huo-Shen-Shan Hospital, Wuhan, China;Jin Yin-tan Hospital, The Medical Team of the Army Medical University, Wuhan, China;Department of Respiratory and Critical Care Medicine, Xinqiao Hospital, The Army Medical University, Chongqing, China;Huo-Shen-Shan Hospital, Wuhan, China;Jin Yin-tan Hospital, The Medical Team of the Army Medical University, Wuhan, China;Xinqiao Hospital, The Army Medical University, Chongqing, China;Taikang Tongji Hospital, Wuhan, China;Department of Respiratory and Critical Care Medicine, Xinqiao Hospital, The Army Medical University, Chongqing, China;Xinqiao Hospital, The Army Medical University, Chongqing, China;Taikang Tongji Hospital, Wuhan, China;

关键词: COVID-19;    mortality;    prediction;    nomogram;    the MuLBSTA score;   

DOI  :  10.3389/fmed.2021.706380

来源: Frontiers

【 摘 要 】

This study aimed to establish and validate the nomograms to predict the mortality risk of patients with coronavirus disease 2019 (COVID-19) using routine clinical indicators. This retrospective study included a development cohort enrolled 2,119 hospitalized patients with COVID-19 and a validation cohort included 1,504 patients with COVID-19. The demographics, clinical manifestations, vital signs, and laboratory tests of the patients at admission and outcome of in-hospital death were recorded. The independent factors associated with death were identified by a forward stepwise multivariate logistic regression analysis and used to construct the two prognostic nomograms. The nomogram 1 was a full model to include nine factors identified in the multivariate logistic regression and nomogram 2 was built by selecting four factors from nine to perform as a reduced model. The nomogram 1 and nomogram 2 showed better performance in discrimination and calibration than the Multilobular infiltration, hypo-Lymphocytosis, Bacterial coinfection, Smoking history, hyper-Tension and Age (MuLBSTA) score in training. In validation, nomogram 1 performed better than nomogram 2 for calibration. We recommend the application of nomogram 1 in general hospitals which provide robust prognostic performance though more cumbersome; nomogram 2 in the out-patient, emergency department, and mobile cabin hospitals, which depend on less laboratory examinations to make the assessment more convenient. Both the nomograms can help the clinicians to identify the patients at risk of death with routine clinical indicators at admission, which may reduce the overall mortality of COVID-19.

【 授权许可】

CC BY