التفاصيل البيبلوغرافية
العنوان: |
Development and validation of a scoring system to predict mortality in patients hospitalized with COVID-19: A retrospective cohort study in two large hospitals in Ecuador |
المؤلفون: |
Dueñas-Espín, Iván, Echeverría-Mora, María, Montenegro-Fárez, Camila, Baldeón, Manuel, Chantong Villacres, Luis, Espejo Cárdenas, Hugo, Fornasini, Marco, Ochoa Andrade, Miguel, Solís, Carlos |
المساهمون: |
Soto, Alonso, Pontificia Universidad Católica del Ecuador |
المصدر: |
PLOS ONE ; volume 18, issue 7, page e0288106 ; ISSN 1932-6203 |
بيانات النشر: |
Public Library of Science (PLoS) |
سنة النشر: |
2023 |
المجموعة: |
PLOS Publications (via CrossRef) |
الوصف: |
Objective To develop and validate a scoring system to predict mortality among hospitalized patients with COVID-19. Methods Retrospective cohort study. We analyzed 5,062 analyzed hospitalized patients with COVID-19 treated at two hospitals; one each in Quito and Guayaquil, from February to July 2020. We assessed predictors of mortality using survival analyses and Cox models. We randomly divided the database into two sets: (i) the derivation cohort (n = 2497) to identify predictors of mortality, and (ii) the validation cohort (n = 2565) to test the discriminative ability of a scoring system. After multivariate analyses, we used the final model’s β-coefficients to build the score. Statistical analyses involved the development of a Cox proportional hazards regression model, assessment of goodness of fit, discrimination, and calibration. Results There was a higher mortality risk for these factors: male sex [(hazard ratio (HR) = 1.32, 95% confidence interval (95% CI): 1.03–1.69], per each increase in a quartile of ages (HR = 1.44, 95% CI: 1.24–1.67) considering the younger group (17–44 years old) as the reference, presence of hypoxemia (HR = 1.40, 95% CI: 1.01–1.95), hypoglycemia and hospital hyperglycemia (HR = 1.99, 95% CI: 1.01–3.91, and HR = 1.27, 95% CI: 0.99–1.62, respectively) when compared with normoglycemia, an AST–ALT ratio >1 (HR = 1.55, 95% CI: 1.25–1.92), C-reactive protein level (CRP) of >10 mg/dL (HR = 1.49, 95% CI: 1.07–2.08), arterial pH <7.35 (HR = 1.39, 95% CI: 1.08–1.80) when compared with normal pH (7.35–7.45), and a white blood cell count >10 × 10 3 per μL (HR = 1.76, 95% CI: 1.35–2.29). We found a strong discriminative ability in the proposed score in the validation cohort [AUC of 0.876 (95% CI: 0.822–0.930)], moreover, a cutoff score ≥39 points demonstrates superior performance with a sensitivity of 93.10%, a specificity of 70.28%, and a correct classification rate of 72.66%. The LR+ (3.1328) and LR- (0.0981) values further support its efficacy in identifying high-risk patients. ... |
نوع الوثيقة: |
article in journal/newspaper |
اللغة: |
English |
DOI: |
10.1371/journal.pone.0288106 |
الإتاحة: |
https://doi.org/10.1371/journal.pone.0288106Test |
حقوق: |
http://creativecommons.org/licenses/by/4.0Test/ |
رقم الانضمام: |
edsbas.12B51A03 |
قاعدة البيانات: |
BASE |