CovidSeniorV1, Main, Exploration, bibRecord, 000740

Clinical risk score to predict in-hospital mortality in COVID-19 patients: a retrospective cohort study.

Identifieur interne : 000740 ( Main/Exploration ); précédent : 000739; suivant : 000741

Clinical risk score to predict in-hospital mortality in COVID-19 patients: a retrospective cohort study.

Auteurs : Carlo Fumagalli [Italie] ; Renzo Rozzini [Italie] ; Matteo Vannini [Italie] ; Flaminia Coccia [Italie] ; Giulia Cesaroni [Italie] ; Francesca Mazzeo [Italie] ; Maria Cola [Italie] ; Alessandro Bartoloni [Italie] ; Paolo Fontanari [Italie] ; Federico Lavorini [Italie] ; Rossella Marcucci [Italie] ; Alessandro Morettini [Italie] ; Carlo Nozzoli [Italie] ; Adriano Peris [Italie] ; Filippo Pieralli [Italie] ; Riccardo Pini [Italie] ; Loredana Poggesi [Italie] ; Andrea Ungar [Italie] ; Stefano Fumagalli [Italie] ; Niccol Marchionni [Italie]

Source :

BMJ open [ 2044-6055 ] ; 2020.

RBID : pubmed:32978207

Descripteurs français

KwdFr :
- Adulte d'âge moyen (MeSH), Appréciation des risques (méthodes), Betacoronavirus (isolement et purification), Femelle (MeSH), Hospitalisation (statistiques et données numériques), Humains (MeSH), Infections à coronavirus (diagnostic), Infections à coronavirus (mortalité), Infections à coronavirus (physiopathologie), Infections à coronavirus (sang), Italie (épidémiologie), Mortalité hospitalière (MeSH), Mâle (MeSH), Pandémies (MeSH), Pneumopathie virale (diagnostic), Pneumopathie virale (mortalité), Pneumopathie virale (physiopathologie), Pneumopathie virale (sang), Programme clinique (normes), Programme clinique (organisation et administration), Pronostic (MeSH), Soins de réanimation (méthodes), Soins de réanimation (statistiques et données numériques), Sujet âgé (MeSH), Triage (méthodes), Triage (statistiques et données numériques), Ventilation artificielle (statistiques et données numériques), Études rétrospectives (MeSH).
MESH :
- diagnostic : Infections à coronavirus, Pneumopathie virale.
- isolement et purification : Betacoronavirus.
- mortalité : Infections à coronavirus, Pneumopathie virale.
- méthodes : Appréciation des risques, Soins de réanimation, Triage.
- normes : Programme clinique.
- organisation et administration : Programme clinique.
- physiopathologie : Infections à coronavirus, Pneumopathie virale.
- sang : Infections à coronavirus, Pneumopathie virale.
- statistiques et données numériques : Hospitalisation, Soins de réanimation, Triage, Ventilation artificielle.
- épidémiologie : Italie.
- Adulte d'âge moyen, Femelle, Humains, Mortalité hospitalière, Mâle, Pandémies, Pronostic, Sujet âgé, Études rétrospectives.
Wicri :
- geographic : Italie.

English descriptors

KwdEn :
- Aged (MeSH), Betacoronavirus (isolation & purification), Coronavirus Infections (blood), Coronavirus Infections (diagnosis), Coronavirus Infections (mortality), Coronavirus Infections (physiopathology), Critical Care (methods), Critical Care (statistics & numerical data), Critical Pathways (organization & administration), Critical Pathways (standards), Female (MeSH), Hospital Mortality (MeSH), Hospitalization (statistics & numerical data), Humans (MeSH), Italy (epidemiology), Male (MeSH), Middle Aged (MeSH), Pandemics (MeSH), Pneumonia, Viral (blood), Pneumonia, Viral (diagnosis), Pneumonia, Viral (mortality), Pneumonia, Viral (physiopathology), Prognosis (MeSH), Respiration, Artificial (statistics & numerical data), Retrospective Studies (MeSH), Risk Assessment (methods), Triage (methods), Triage (statistics & numerical data).
MESH :
- geographic , epidemiology : Italy.
- blood : Coronavirus Infections, Pneumonia, Viral.
- diagnosis : Coronavirus Infections, Pneumonia, Viral.
- isolation & purification : Betacoronavirus.
- methods : Critical Care, Risk Assessment, Triage.
- mortality : Coronavirus Infections, Pneumonia, Viral.
- organization & administration : Critical Pathways.
- physiopathology : Coronavirus Infections, Pneumonia, Viral.
- standards : Critical Pathways.
- statistics & numerical data : Critical Care, Hospitalization, Respiration, Artificial, Triage.
- Aged, Female, Hospital Mortality, Humans, Male, Middle Aged, Pandemics, Prognosis, Retrospective Studies.

Abstract

OBJECTIVES

Several physiological abnormalities that develop during COVID-19 are associated with increased mortality. In the present study, we aimed to develop a clinical risk score to predict the in-hospital mortality in COVID-19 patients, based on a set of variables available soon after the hospitalisation triage.

SETTING

Retrospective cohort study of 516 patients consecutively admitted for COVID-19 to two Italian tertiary hospitals located in Northern and Central Italy were collected from 22 February 2020 (date of first admission) to 10 April 2020.

PARTICIPANTS

Consecutive patients≥18 years admitted for COVID-19.

MAIN OUTCOME MEASURES

Simple clinical and laboratory findings readily available after triage were compared by patients' survival status ('dead' vs 'alive'), with the objective of identifying baseline variables associated with mortality. These were used to build a COVID-19 in-hospital mortality risk score (COVID-19MRS).

RESULTS

Mean age was 67±13 years (mean±SD), and 66.9% were male. Using Cox regression analysis, tertiles of increasing age (≥75, upper vs <62 years, lower: HR 7.92; p<0.001) and number of chronic diseases (≥4 vs 0-1: HR 2.09; p=0.007), respiratory rate (HR 1.04 per unit increase; p=0.001), PaO

CONCLUSIONS

The COVID-19MRS is a rapid, operator-independent and inexpensive clinical tool that objectively predicts mortality in patients with COVID-19. The score could be helpful from triage to guide earlier assignment of COVID-19 patients to the most appropriate level of care.

DOI: 10.1136/bmjopen-2020-040729
PubMed: 32978207
PubMed Central: PMC7520809

Affiliations:

Italie

Links toward previous steps (curation, corpus...)

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Le document en format XML

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<author><name sortKey="Poggesi, Loredana" sort="Poggesi, Loredana" uniqKey="Poggesi L" first="Loredana" last="Poggesi">Loredana Poggesi</name>
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<author><name sortKey="Ungar, Andrea" sort="Ungar, Andrea" uniqKey="Ungar A" first="Andrea" last="Ungar">Andrea Ungar</name>
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<author><name sortKey="Fumagalli, Stefano" sort="Fumagalli, Stefano" uniqKey="Fumagalli S" first="Stefano" last="Fumagalli">Stefano Fumagalli</name>
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<sourceDesc><biblStruct><analytic><title xml:lang="en">Clinical risk score to predict in-hospital mortality in COVID-19 patients: a retrospective cohort study.</title>
<author><name sortKey="Fumagalli, Carlo" sort="Fumagalli, Carlo" uniqKey="Fumagalli C" first="Carlo" last="Fumagalli">Carlo Fumagalli</name>
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<author><name sortKey="Rozzini, Renzo" sort="Rozzini, Renzo" uniqKey="Rozzini R" first="Renzo" last="Rozzini">Renzo Rozzini</name>
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<country xml:lang="fr">Italie</country>
<wicri:regionArea>Department of Internal Medicine and Geriatrics, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Lombardy</wicri:regionArea>
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<author><name sortKey="Vannini, Matteo" sort="Vannini, Matteo" uniqKey="Vannini M" first="Matteo" last="Vannini">Matteo Vannini</name>
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<author><name sortKey="Coccia, Flaminia" sort="Coccia, Flaminia" uniqKey="Coccia F" first="Flaminia" last="Coccia">Flaminia Coccia</name>
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<country xml:lang="fr">Italie</country>
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<author><name sortKey="Cesaroni, Giulia" sort="Cesaroni, Giulia" uniqKey="Cesaroni G" first="Giulia" last="Cesaroni">Giulia Cesaroni</name>
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<author><name sortKey="Mazzeo, Francesca" sort="Mazzeo, Francesca" uniqKey="Mazzeo F" first="Francesca" last="Mazzeo">Francesca Mazzeo</name>
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<country xml:lang="fr">Italie</country>
<wicri:regionArea>Department of Internal Medicine and Geriatrics, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Lombardy</wicri:regionArea>
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<author><name sortKey="Cola, Maria" sort="Cola, Maria" uniqKey="Cola M" first="Maria" last="Cola">Maria Cola</name>
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<author><name sortKey="Bartoloni, Alessandro" sort="Bartoloni, Alessandro" uniqKey="Bartoloni A" first="Alessandro" last="Bartoloni">Alessandro Bartoloni</name>
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<affiliation wicri:level="1"><nlm:affiliation>Department of Internal and Emergency Medicine, Careggi Hospital, Florence, Italy.</nlm:affiliation>
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<author><name sortKey="Fontanari, Paolo" sort="Fontanari, Paolo" uniqKey="Fontanari P" first="Paolo" last="Fontanari">Paolo Fontanari</name>
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<country xml:lang="fr">Italie</country>
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<wicri:noRegion>Florence</wicri:noRegion>
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<author><name sortKey="Lavorini, Federico" sort="Lavorini, Federico" uniqKey="Lavorini F" first="Federico" last="Lavorini">Federico Lavorini</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.</nlm:affiliation>
<country xml:lang="fr">Italie</country>
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<affiliation wicri:level="1"><nlm:affiliation>Department of Cardiothoracovascular Medicine, Careggi Hospital, Florence, Italy.</nlm:affiliation>
<country xml:lang="fr">Italie</country>
<wicri:regionArea>Department of Cardiothoracovascular Medicine, Careggi Hospital, Florence</wicri:regionArea>
<wicri:noRegion>Florence</wicri:noRegion>
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<author><name sortKey="Marcucci, Rossella" sort="Marcucci, Rossella" uniqKey="Marcucci R" first="Rossella" last="Marcucci">Rossella Marcucci</name>
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<country xml:lang="fr">Italie</country>
<wicri:regionArea>Department of Experimental and Clinical Medicine, University of Florence, Florence</wicri:regionArea>
<wicri:noRegion>Florence</wicri:noRegion>
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<affiliation wicri:level="1"><nlm:affiliation>Department of Cardiothoracovascular Medicine, Careggi Hospital, Florence, Italy.</nlm:affiliation>
<country xml:lang="fr">Italie</country>
<wicri:regionArea>Department of Cardiothoracovascular Medicine, Careggi Hospital, Florence</wicri:regionArea>
<wicri:noRegion>Florence</wicri:noRegion>
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</author>
<author><name sortKey="Morettini, Alessandro" sort="Morettini, Alessandro" uniqKey="Morettini A" first="Alessandro" last="Morettini">Alessandro Morettini</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Internal and Emergency Medicine, Careggi Hospital, Florence, Italy.</nlm:affiliation>
<country xml:lang="fr">Italie</country>
<wicri:regionArea>Department of Internal and Emergency Medicine, Careggi Hospital, Florence</wicri:regionArea>
<wicri:noRegion>Florence</wicri:noRegion>
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</author>
<author><name sortKey="Nozzoli, Carlo" sort="Nozzoli, Carlo" uniqKey="Nozzoli C" first="Carlo" last="Nozzoli">Carlo Nozzoli</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Internal and Emergency Medicine, Careggi Hospital, Florence, Italy.</nlm:affiliation>
<country xml:lang="fr">Italie</country>
<wicri:regionArea>Department of Internal and Emergency Medicine, Careggi Hospital, Florence</wicri:regionArea>
<wicri:noRegion>Florence</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Peris, Adriano" sort="Peris, Adriano" uniqKey="Peris A" first="Adriano" last="Peris">Adriano Peris</name>
<affiliation wicri:level="1"><nlm:affiliation>Intensive Care Unit and Regional ECMO Referral Center, Careggi Hospital, Florence, Italy.</nlm:affiliation>
<country xml:lang="fr">Italie</country>
<wicri:regionArea>Intensive Care Unit and Regional ECMO Referral Center, Careggi Hospital, Florence</wicri:regionArea>
<wicri:noRegion>Florence</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Pieralli, Filippo" sort="Pieralli, Filippo" uniqKey="Pieralli F" first="Filippo" last="Pieralli">Filippo Pieralli</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Internal and Emergency Medicine, Careggi Hospital, Florence, Italy.</nlm:affiliation>
<country xml:lang="fr">Italie</country>
<wicri:regionArea>Department of Internal and Emergency Medicine, Careggi Hospital, Florence</wicri:regionArea>
<wicri:noRegion>Florence</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Pini, Riccardo" sort="Pini, Riccardo" uniqKey="Pini R" first="Riccardo" last="Pini">Riccardo Pini</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.</nlm:affiliation>
<country xml:lang="fr">Italie</country>
<wicri:regionArea>Department of Experimental and Clinical Medicine, University of Florence, Florence</wicri:regionArea>
<wicri:noRegion>Florence</wicri:noRegion>
</affiliation>
<affiliation wicri:level="1"><nlm:affiliation>Department of Internal and Emergency Medicine, Careggi Hospital, Florence, Italy.</nlm:affiliation>
<country xml:lang="fr">Italie</country>
<wicri:regionArea>Department of Internal and Emergency Medicine, Careggi Hospital, Florence</wicri:regionArea>
<wicri:noRegion>Florence</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Poggesi, Loredana" sort="Poggesi, Loredana" uniqKey="Poggesi L" first="Loredana" last="Poggesi">Loredana Poggesi</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.</nlm:affiliation>
<country xml:lang="fr">Italie</country>
<wicri:regionArea>Department of Experimental and Clinical Medicine, University of Florence, Florence</wicri:regionArea>
<wicri:noRegion>Florence</wicri:noRegion>
</affiliation>
<affiliation wicri:level="1"><nlm:affiliation>Department of Internal and Emergency Medicine, Careggi Hospital, Florence, Italy.</nlm:affiliation>
<country xml:lang="fr">Italie</country>
<wicri:regionArea>Department of Internal and Emergency Medicine, Careggi Hospital, Florence</wicri:regionArea>
<wicri:noRegion>Florence</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Ungar, Andrea" sort="Ungar, Andrea" uniqKey="Ungar A" first="Andrea" last="Ungar">Andrea Ungar</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.</nlm:affiliation>
<country xml:lang="fr">Italie</country>
<wicri:regionArea>Department of Experimental and Clinical Medicine, University of Florence, Florence</wicri:regionArea>
<wicri:noRegion>Florence</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Fumagalli, Stefano" sort="Fumagalli, Stefano" uniqKey="Fumagalli S" first="Stefano" last="Fumagalli">Stefano Fumagalli</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.</nlm:affiliation>
<country xml:lang="fr">Italie</country>
<wicri:regionArea>Department of Experimental and Clinical Medicine, University of Florence, Florence</wicri:regionArea>
<wicri:noRegion>Florence</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Marchionni, Niccol" sort="Marchionni, Niccol" uniqKey="Marchionni N" first="Niccol" last="Marchionni">Niccol Marchionni</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy niccolo.marchionni@unifi.it.</nlm:affiliation>
<country wicri:rule="url">Italie</country>
<wicri:regionArea>Department of Experimental and Clinical Medicine, University of Florence, Florence</wicri:regionArea>
<wicri:noRegion>Florence</wicri:noRegion>
</affiliation>
<affiliation wicri:level="1"><nlm:affiliation>Department of Cardiothoracovascular Medicine, Careggi Hospital, Florence, Italy.</nlm:affiliation>
<country xml:lang="fr">Italie</country>
<wicri:regionArea>Department of Cardiothoracovascular Medicine, Careggi Hospital, Florence</wicri:regionArea>
<wicri:noRegion>Florence</wicri:noRegion>
</affiliation>
</author>
</analytic>
<series><title level="j">BMJ open</title>
<idno type="eISSN">2044-6055</idno>
<imprint><date when="2020" type="published">2020</date>
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<term>Betacoronavirus (isolation & purification)</term>
<term>Coronavirus Infections (blood)</term>
<term>Coronavirus Infections (diagnosis)</term>
<term>Coronavirus Infections (mortality)</term>
<term>Coronavirus Infections (physiopathology)</term>
<term>Critical Care (methods)</term>
<term>Critical Care (statistics & numerical data)</term>
<term>Critical Pathways (organization & administration)</term>
<term>Critical Pathways (standards)</term>
<term>Female (MeSH)</term>
<term>Hospital Mortality (MeSH)</term>
<term>Hospitalization (statistics & numerical data)</term>
<term>Humans (MeSH)</term>
<term>Italy (epidemiology)</term>
<term>Male (MeSH)</term>
<term>Middle Aged (MeSH)</term>
<term>Pandemics (MeSH)</term>
<term>Pneumonia, Viral (blood)</term>
<term>Pneumonia, Viral (diagnosis)</term>
<term>Pneumonia, Viral (mortality)</term>
<term>Pneumonia, Viral (physiopathology)</term>
<term>Prognosis (MeSH)</term>
<term>Respiration, Artificial (statistics & numerical data)</term>
<term>Retrospective Studies (MeSH)</term>
<term>Risk Assessment (methods)</term>
<term>Triage (methods)</term>
<term>Triage (statistics & numerical data)</term>
</keywords>
<keywords scheme="KwdFr" xml:lang="fr"><term>Adulte d'âge moyen (MeSH)</term>
<term>Appréciation des risques (méthodes)</term>
<term>Betacoronavirus (isolement et purification)</term>
<term>Femelle (MeSH)</term>
<term>Hospitalisation (statistiques et données numériques)</term>
<term>Humains (MeSH)</term>
<term>Infections à coronavirus (diagnostic)</term>
<term>Infections à coronavirus (mortalité)</term>
<term>Infections à coronavirus (physiopathologie)</term>
<term>Infections à coronavirus (sang)</term>
<term>Italie (épidémiologie)</term>
<term>Mortalité hospitalière (MeSH)</term>
<term>Mâle (MeSH)</term>
<term>Pandémies (MeSH)</term>
<term>Pneumopathie virale (diagnostic)</term>
<term>Pneumopathie virale (mortalité)</term>
<term>Pneumopathie virale (physiopathologie)</term>
<term>Pneumopathie virale (sang)</term>
<term>Programme clinique (normes)</term>
<term>Programme clinique (organisation et administration)</term>
<term>Pronostic (MeSH)</term>
<term>Soins de réanimation (méthodes)</term>
<term>Soins de réanimation (statistiques et données numériques)</term>
<term>Sujet âgé (MeSH)</term>
<term>Triage (méthodes)</term>
<term>Triage (statistiques et données numériques)</term>
<term>Ventilation artificielle (statistiques et données numériques)</term>
<term>Études rétrospectives (MeSH)</term>
</keywords>
<keywords scheme="MESH" type="geographic" qualifier="epidemiology" xml:lang="en"><term>Italy</term>
</keywords>
<keywords scheme="MESH" qualifier="blood" xml:lang="en"><term>Coronavirus Infections</term>
<term>Pneumonia, Viral</term>
</keywords>
<keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Coronavirus Infections</term>
<term>Pneumonia, Viral</term>
</keywords>
<keywords scheme="MESH" qualifier="diagnostic" xml:lang="fr"><term>Infections à coronavirus</term>
<term>Pneumopathie virale</term>
</keywords>
<keywords scheme="MESH" qualifier="isolation & purification" xml:lang="en"><term>Betacoronavirus</term>
</keywords>
<keywords scheme="MESH" qualifier="isolement et purification" xml:lang="fr"><term>Betacoronavirus</term>
</keywords>
<keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Critical Care</term>
<term>Risk Assessment</term>
<term>Triage</term>
</keywords>
<keywords scheme="MESH" qualifier="mortality" xml:lang="en"><term>Coronavirus Infections</term>
<term>Pneumonia, Viral</term>
</keywords>
<keywords scheme="MESH" qualifier="mortalité" xml:lang="fr"><term>Infections à coronavirus</term>
<term>Pneumopathie virale</term>
</keywords>
<keywords scheme="MESH" qualifier="méthodes" xml:lang="fr"><term>Appréciation des risques</term>
<term>Soins de réanimation</term>
<term>Triage</term>
</keywords>
<keywords scheme="MESH" qualifier="normes" xml:lang="fr"><term>Programme clinique</term>
</keywords>
<keywords scheme="MESH" qualifier="organisation et administration" xml:lang="fr"><term>Programme clinique</term>
</keywords>
<keywords scheme="MESH" qualifier="organization & administration" xml:lang="en"><term>Critical Pathways</term>
</keywords>
<keywords scheme="MESH" qualifier="physiopathologie" xml:lang="fr"><term>Infections à coronavirus</term>
<term>Pneumopathie virale</term>
</keywords>
<keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Coronavirus Infections</term>
<term>Pneumonia, Viral</term>
</keywords>
<keywords scheme="MESH" qualifier="sang" xml:lang="fr"><term>Infections à coronavirus</term>
<term>Pneumopathie virale</term>
</keywords>
<keywords scheme="MESH" qualifier="standards" xml:lang="en"><term>Critical Pathways</term>
</keywords>
<keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Critical Care</term>
<term>Hospitalization</term>
<term>Respiration, Artificial</term>
<term>Triage</term>
</keywords>
<keywords scheme="MESH" qualifier="statistiques et données numériques" xml:lang="fr"><term>Hospitalisation</term>
<term>Soins de réanimation</term>
<term>Triage</term>
<term>Ventilation artificielle</term>
</keywords>
<keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Italie</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Aged</term>
<term>Female</term>
<term>Hospital Mortality</term>
<term>Humans</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Pandemics</term>
<term>Prognosis</term>
<term>Retrospective Studies</term>
</keywords>
<keywords scheme="MESH" xml:lang="fr"><term>Adulte d'âge moyen</term>
<term>Femelle</term>
<term>Humains</term>
<term>Mortalité hospitalière</term>
<term>Mâle</term>
<term>Pandémies</term>
<term>Pronostic</term>
<term>Sujet âgé</term>
<term>Études rétrospectives</term>
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<keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>Italie</term>
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<front><div type="abstract" xml:lang="en"><p><b>OBJECTIVES</b>
</p>
<p>Several physiological abnormalities that develop during COVID-19 are associated with increased mortality. In the present study, we aimed to develop a clinical risk score to predict the in-hospital mortality in COVID-19 patients, based on a set of variables available soon after the hospitalisation triage.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>SETTING</b>
</p>
<p>Retrospective cohort study of 516 patients consecutively admitted for COVID-19 to two Italian tertiary hospitals located in Northern and Central Italy were collected from 22 February 2020 (date of first admission) to 10 April 2020.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>PARTICIPANTS</b>
</p>
<p>Consecutive patients≥18 years admitted for COVID-19.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>MAIN OUTCOME MEASURES</b>
</p>
<p>Simple clinical and laboratory findings readily available after triage were compared by patients' survival status ('dead' vs 'alive'), with the objective of identifying baseline variables associated with mortality. These were used to build a COVID-19 in-hospital mortality risk score (COVID-19MRS).</p>
</div>
<div type="abstract" xml:lang="en"><p><b>RESULTS</b>
</p>
<p>Mean age was 67±13 years (mean±SD), and 66.9% were male. Using Cox regression analysis, tertiles of increasing age (≥75, upper vs <62 years, lower: HR 7.92; p<0.001) and number of chronic diseases (≥4 vs 0-1: HR 2.09; p=0.007), respiratory rate (HR 1.04 per unit increase; p=0.001), PaO</p>
</div>
<div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b>
</p>
<p>The COVID-19MRS is a rapid, operator-independent and inexpensive clinical tool that objectively predicts mortality in patients with COVID-19. The score could be helpful from triage to guide earlier assignment of COVID-19 patients to the most appropriate level of care.</p>
</div>
</front>
</TEI>
<pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">32978207</PMID>
<DateCompleted><Year>2020</Year>
<Month>10</Month>
<Day>13</Day>
</DateCompleted>
<DateRevised><Year>2020</Year>
<Month>10</Month>
<Day>13</Day>
</DateRevised>
<Article PubModel="Electronic"><Journal><ISSN IssnType="Electronic">2044-6055</ISSN>
<JournalIssue CitedMedium="Internet"><Volume>10</Volume>
<Issue>9</Issue>
<PubDate><Year>2020</Year>
<Month>09</Month>
<Day>25</Day>
</PubDate>
</JournalIssue>
<Title>BMJ open</Title>
<ISOAbbreviation>BMJ Open</ISOAbbreviation>
</Journal>
<ArticleTitle>Clinical risk score to predict in-hospital mortality in COVID-19 patients: a retrospective cohort study.</ArticleTitle>
<Pagination><MedlinePgn>e040729</MedlinePgn>
</Pagination>
<ELocationID EIdType="doi" ValidYN="Y">10.1136/bmjopen-2020-040729</ELocationID>
<Abstract><AbstractText Label="OBJECTIVES">Several physiological abnormalities that develop during COVID-19 are associated with increased mortality. In the present study, we aimed to develop a clinical risk score to predict the in-hospital mortality in COVID-19 patients, based on a set of variables available soon after the hospitalisation triage.</AbstractText>
<AbstractText Label="SETTING">Retrospective cohort study of 516 patients consecutively admitted for COVID-19 to two Italian tertiary hospitals located in Northern and Central Italy were collected from 22 February 2020 (date of first admission) to 10 April 2020.</AbstractText>
<AbstractText Label="PARTICIPANTS">Consecutive patients≥18 years admitted for COVID-19.</AbstractText>
<AbstractText Label="MAIN OUTCOME MEASURES">Simple clinical and laboratory findings readily available after triage were compared by patients' survival status ('dead' vs 'alive'), with the objective of identifying baseline variables associated with mortality. These were used to build a COVID-19 in-hospital mortality risk score (COVID-19MRS).</AbstractText>
<AbstractText Label="RESULTS">Mean age was 67±13 years (mean±SD), and 66.9% were male. Using Cox regression analysis, tertiles of increasing age (≥75, upper vs <62 years, lower: HR 7.92; p<0.001) and number of chronic diseases (≥4 vs 0-1: HR 2.09; p=0.007), respiratory rate (HR 1.04 per unit increase; p=0.001), PaO<sub>2</sub>
/FiO<sub>2</sub>
 (HR 0.995 per unit increase; p<0.001), serum creatinine (HR 1.34 per unit increase; p<0.001) and platelet count (HR 0.995 per unit increase; p=0.001) were predictors of mortality. All six predictors were used to build the COVID-19MRS (Area Under the Curve 0.90, 95% CI 0.87 to 0.93), which proved to be highly accurate in stratifying patients at low, intermediate and high risk of in-hospital death (p<0.001).</AbstractText>
<AbstractText Label="CONCLUSIONS">The COVID-19MRS is a rapid, operator-independent and inexpensive clinical tool that objectively predicts mortality in patients with COVID-19. The score could be helpful from triage to guide earlier assignment of COVID-19 patients to the most appropriate level of care.</AbstractText>
<CopyrightInformation>© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.</CopyrightInformation>
</Abstract>
<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Fumagalli</LastName>
<ForeName>Carlo</ForeName>
<Initials>C</Initials>
<Identifier Source="ORCID">0000-0001-7963-5049</Identifier>
<AffiliationInfo><Affiliation>Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Rozzini</LastName>
<ForeName>Renzo</ForeName>
<Initials>R</Initials>
<AffiliationInfo><Affiliation>Department of Internal Medicine and Geriatrics, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Lombardy, Italy.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Vannini</LastName>
<ForeName>Matteo</ForeName>
<Initials>M</Initials>
<AffiliationInfo><Affiliation>Department of Cardiothoracovascular Medicine, Careggi Hospital, Florence, Italy.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Coccia</LastName>
<ForeName>Flaminia</ForeName>
<Initials>F</Initials>
<AffiliationInfo><Affiliation>Department of Internal Medicine and Geriatrics, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Lombardy, Italy.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Cesaroni</LastName>
<ForeName>Giulia</ForeName>
<Initials>G</Initials>
<AffiliationInfo><Affiliation>Department of Internal Medicine and Geriatrics, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Lombardy, Italy.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Mazzeo</LastName>
<ForeName>Francesca</ForeName>
<Initials>F</Initials>
<AffiliationInfo><Affiliation>Department of Internal Medicine and Geriatrics, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Lombardy, Italy.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Cola</LastName>
<ForeName>Maria</ForeName>
<Initials>M</Initials>
<AffiliationInfo><Affiliation>Department of Internal and Emergency Medicine, Careggi Hospital, Florence, Italy.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Bartoloni</LastName>
<ForeName>Alessandro</ForeName>
<Initials>A</Initials>
<AffiliationInfo><Affiliation>Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Department of Internal and Emergency Medicine, Careggi Hospital, Florence, Italy.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Fontanari</LastName>
<ForeName>Paolo</ForeName>
<Initials>P</Initials>
<AffiliationInfo><Affiliation>Department of Cardiothoracovascular Medicine, Careggi Hospital, Florence, Italy.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Lavorini</LastName>
<ForeName>Federico</ForeName>
<Initials>F</Initials>
<AffiliationInfo><Affiliation>Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Department of Cardiothoracovascular Medicine, Careggi Hospital, Florence, Italy.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Marcucci</LastName>
<ForeName>Rossella</ForeName>
<Initials>R</Initials>
<AffiliationInfo><Affiliation>Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Department of Cardiothoracovascular Medicine, Careggi Hospital, Florence, Italy.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Morettini</LastName>
<ForeName>Alessandro</ForeName>
<Initials>A</Initials>
<AffiliationInfo><Affiliation>Department of Internal and Emergency Medicine, Careggi Hospital, Florence, Italy.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Nozzoli</LastName>
<ForeName>Carlo</ForeName>
<Initials>C</Initials>
<AffiliationInfo><Affiliation>Department of Internal and Emergency Medicine, Careggi Hospital, Florence, Italy.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Peris</LastName>
<ForeName>Adriano</ForeName>
<Initials>A</Initials>
<AffiliationInfo><Affiliation>Intensive Care Unit and Regional ECMO Referral Center, Careggi Hospital, Florence, Italy.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Pieralli</LastName>
<ForeName>Filippo</ForeName>
<Initials>F</Initials>
<AffiliationInfo><Affiliation>Department of Internal and Emergency Medicine, Careggi Hospital, Florence, Italy.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Pini</LastName>
<ForeName>Riccardo</ForeName>
<Initials>R</Initials>
<AffiliationInfo><Affiliation>Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Department of Internal and Emergency Medicine, Careggi Hospital, Florence, Italy.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Poggesi</LastName>
<ForeName>Loredana</ForeName>
<Initials>L</Initials>
<AffiliationInfo><Affiliation>Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Department of Internal and Emergency Medicine, Careggi Hospital, Florence, Italy.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Ungar</LastName>
<ForeName>Andrea</ForeName>
<Initials>A</Initials>
<AffiliationInfo><Affiliation>Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Fumagalli</LastName>
<ForeName>Stefano</ForeName>
<Initials>S</Initials>
<AffiliationInfo><Affiliation>Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Marchionni</LastName>
<ForeName>Niccolò</ForeName>
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   |texte=   Clinical risk score to predict in-hospital mortality in COVID-19 patients: a retrospective cohort study.
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	Serveur d'exploration sur la COVID chez les séniors
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Serveur d'exploration sur la COVID chez les séniors

Clinical risk score to predict in-hospital mortality in COVID-19 patients: a retrospective cohort study.

Clinical risk score to predict in-hospital mortality in COVID-19 patients: a retrospective cohort study.

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