PURPOSE: Multiple scoring systems were used for risk stratification in COVID-19 patients. The objective was to determine among 6 scores which performed the best in predicting short-and long-term mortality in hospitalized COVID-19 patients ≥ 60 years.
METHODS: An observational, retrospective cohort study conducted between 21/10/2020 - 20/01/2021. 6 scores were calculated (Clinical Frailty Scale (CFS), Charlson Comorbidity Index (CCI), 4C Mortality Score (4CMS), NEWS score (NEWS), quick-SOFA score (qSOFA), and Quick COVID-19 Severity Index (qCSI)). We included unvaccinated hospitalized patients with COVID-19 ≥ 60 years old in Brugmann hospital, detected by PCR and/or suggestive CT thorax images. Old and nosocomial infections, and patients admitted immediately at the intensive care unit were excluded.
RESULTS: 199 patients were included, mean age was 76.2 years (60 - 99). 56 patients (28%) died within 1 year after the first day of hospitalization. The 4CMS predicted the best intrahospital, 30 days and 6 months mortality, with area under the ROC curve (AUROC) 0.695 (0.59-0.8), 0.76 (0.66-0.86) and 0.73 (0.64-0.82) respectively. The CCI came right after with respectively AUROC of 0.68 (0.58-0.77), 0.74 (0.66-0.82) and 0.72 (0.64-0.8). To predict mortality at 12 months after hospitalization, the CCI had the highest AUROC with 0.74 (0.66-0.81), before the 4CMS with 0.695 (0.61-0.78). CONCLUSION: Among 6 scores, the 4CMS was the best to predict intrahospital, 30-day and 6-month mortality. To predict mortality at 12 months, CCI had the best performance before 4CMS. This reflects the importance of considering comorbidities for short- and long-term mortality after COVID 19.
Comparison of different prognostic scores in estimating short-and long-term mortality in COVID-19 patientsabove 60 years old in a university hospital in Belgium.
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