학술논문
Predictors of mortality among hospitalized COVID-19 patients and risk score formulation for prioritizing tertiary care-An experience from South India
Document Type
Report
Author
Gopalan, Narendran; Senthil, Sumathi; Prabakar, Narmadha Lakshmi; Senguttuvan, Thirumaran; Bhaskar, Adhin; Jagannathan, Muthukumaran; Sivaraman, Ravi; Ramasamy, Jayalakshmi; Chinnaiyan, Ponnuraja; Arumugam, Vijayalakshmi; Getrude, Banumathy; Sakthivel, Gautham; Srinivasalu, Vignes Anand; Rajendran, Dhanalakshmi; Nadukkandiyil, Arunjith; Ravi, Vaishnavi; Hifzour Rahamane, Sadiqa Nasreen; Athur Paramasivam, Nirmal; Manoharan, Tamizhselvan; Theyagarajan, Maheshwari; Chadha, Vineet Kumar; Natrajan, Mohan; Dhanaraj, Baskaran; Murhekar, Manoj Vasant; Ramalingam, Shanthi Malar; Chandrasekaran, Padmapriyadarsini
Source
PLoS ONE. February 3, 2022, Vol. 17 Issue 2, e0263471
Subject
Language
English
ISSN
1932-6203
Abstract
Background We retrospectively data-mined the case records of Reverse Transcription Polymerase Chain Reaction (RT-PCR) confirmed COVID-19 patients hospitalized to a tertiary care centre to derive mortality predictors and formulate a risk score, for prioritizing admission. Methods and findings Data on clinical manifestations, comorbidities, vital signs, and basic lab investigations collected as part of routine medical management at admission to a COVID-19 tertiary care centre in Chengalpattu, South India between May and November 2020 were retrospectively analysed to ascertain predictors of mortality in the univariate analysis using their relative difference in distribution among 'survivors' and 'non-survivors'. The regression coefficients of those factors remaining significant in the multivariable logistic regression were utilised for risk score formulation and validated in 1000 bootstrap datasets. Among 746 COVID-19 patients hospitalised [487 "survivors" and 259 "non-survivors" (deaths)], there was a slight male predilection [62.5%, (466/746)], with a higher mortality rate observed among 40-70 years age group [59.1%, (441/746)] and highest among diabetic patients with elevated urea levels [65.4% (68/104)]. The adjusted odds ratios of factors [OR (95% CI)] significant in the multivariable logistic regression were SaO.sub.2 3; 3.01 (1.61-5.83), Age [greater than or equal to]50 years;2.52 (1.45-4.43), Pulse Rate [greater than or equal to]100/min: 2.02 (1.19-3.47) and coexisting Diabetes Mellitus; 1.73 (1.02-2.95) with hypertension and gender not retaining their significance. The individual risk scores for SaO.sub.2 3-11, Age [greater than or equal to]50 years-9, Pulse Rate [greater than or equal to]100/min-7 and coexisting diabetes mellitus-6, acronymed collectively as 'OUR-ARDs score' showed that the sum of scores [greater than or equal to] 25 predicted mortality with a sensitivity-90%, specificity-64% and AUC of 0.85. Conclusions The 'OUR ARDs' risk score, derived from easily assessable factors predicting mortality, offered a tangible solution for prioritizing admission to COVID-19 tertiary care centre, that enhanced patient care but without unduly straining the health system.
Author(s): Narendran Gopalan 1,*, Sumathi Senthil 2, Narmadha Lakshmi Prabakar 2, Thirumaran Senguttuvan 1, Adhin Bhaskar 3, Muthukumaran Jagannathan 4, Ravi Sivaraman 5, Jayalakshmi Ramasamy 2, Ponnuraja Chinnaiyan 3, Vijayalakshmi [...]
Author(s): Narendran Gopalan 1,*, Sumathi Senthil 2, Narmadha Lakshmi Prabakar 2, Thirumaran Senguttuvan 1, Adhin Bhaskar 3, Muthukumaran Jagannathan 4, Ravi Sivaraman 5, Jayalakshmi Ramasamy 2, Ponnuraja Chinnaiyan 3, Vijayalakshmi [...]