Comparison of the Performance of Various Scores in Predicting Mortality Among Patients Hospitalized With COVID-19

Abstract

Introduction Coronavirus disease 2019 (COVID-19) is a major social and economic challenge, devastating the health care system in several countries around the world. Mortality scores are important as they can help health care professionals to plan treatment as per the patients' condition for proper resource allocation. When it comes to patients, it provides invaluable information for implementing advance directives. The aim of the study is to validate mortality scores for predicting in-hospital mortality in patients with COVID-19. Methodology This was a retrospective cohort study that included data from three tertiary care hospitals in Karachi, Pakistan. Data of patients diagnosed with confirmed COVID-19 infection and hospitalized in Ziauddin Hospital, Aga Khan Hospital, and Liaquat National Hospital were enrolled in the study from November 1, 2020, to April 30, 2021. Data was extracted from the hospital management information system (HMIS) using a structured questionnaire. Results Overall, 835 patients were included in the final analysis. The mean age of patients was 53.29 (SD ± 15.17) years, and 675 patients (80.72%) were males. The sensitivity of the CALL score is highest among all four scores, i.e., 77.25%, and the quick Sequential Organ Failure Assessment (qSOFA) score has the lowest sensitivity (59.79%). However, CALL has the lowest specificity (58.04%), while qSOFA has the highest specificity (73.91%). However, MulBSTA and CRB-65 have a sensitivity of 70.11% and 64.96%, respectively. Conclusion The current study showed that the CALL score had better sensitivity as compared to other mortality scores.

“Underneath the visible” - COVID-19 Risk prediction tools in a high-volume, low-resource Emergency Department

“…In our study, CALL Score depicted sub-optimal performance for both outcome variables as also noted in a Peruvian study. 22 In contrast, Jilanee et al 1 reported better sensitivity. This may be explained by lack of inclusion of respiratory parameters, essential for predicting disease progression.…”

“…There was male predominance with disease prevalence in >50 years of age in congruity with local 1,5,9,[16][17][18][19] and international literature. 20 Akin to Nava et al 14 , all strategies for COVID-19 severity evaluation in our study depicted the increasing trend of ICU admission and mortality with worsening risk class.…”

“…7 Without clear guidelines and risk prediction tools to effectively allocate resources; the situation was worsened by acute scarcity of ICU beds. 1,3 With the aim of strategic redistribution of hospital resources in a frail health infrastructure; 10 this study was designed to evaluate the performance of the CALL Score, BCRSS, and WHO guidelines in predicting outcomes i.e. ICU admission and in-hospital mortality.…”

“…The unwavering COVID-19 pandemic has affected economies and health infrastructures globally 1,2 , especially low and middle-income countries (LMIC's)…”

“…8 The CALL (Comorbidity, Age, Lymphocytes, Lactate dehydrogenase [LDH]) score has also been shown to predict disease progression and inhospital mortality in with; sensitivity 77.25%, specificity 58%, positive predictive value 57.77% and negative predictive value 77.44%. 1 IHHN is a free of cost, tertiary care center situated in district Korangi, Karachi, Pakistan. The ED provides…”