In Intubated COVID-19 Patients a New Score Predicts Early Death Risk

According to a recent study, a unique predictive score has adequate accuracy for predicting early mortality in intubated patients with the coronavirus disease 2019 (COVID-19).

In Intubated COVID-19 Patients a New Score Predicts Early Death Risk
Photo: Senior Patient with COVID-19 | InStyleHealth


The researchers used a logistic regression model on a retrospective dataset of 1,389 intubated COVID-19 patients (median age 65 years, 69.4% men) admitted to 12 New York City hospitals to construct the prediction score. A total of 556 patients were used in the external validation study (median age 67 years, 65.8 percent men).

The derivation and validation cohorts had death rates of 43.8 percent and 48.0 percent, respectively, after 14 days. Age, past history of chronic kidney disease (CKD), mean arterial pressure (MAP) and need for vasopressors, oxygen index, and blood urea nitrogen (BUN), ferritin, and pH were identified as seven major prognostic variables in the derivation cohort.

The Intubated COVID-19 Predictive score (ICOP) was created by combining all of the above parameters, and it ranges from 0 to 100 percent, indicating the lowest to highest chance of early mortality after intubation.

Furthermore, in both the derivation and validation cohorts, ICOP performed much better than established measures such as the sequential organ failure assessment and CURB-65* at predicting early mortality.

"In external validation, the areas under the curve of these scores were larger than 0.7, which is considered an acceptable predictive accuracy," the researchers noted.

"We believe that risk stratification based on the ICOP score is most useful in actual clinical practice for guiding joint decision-making among patients' families and medical staff in regard to future treatment options, distinguishing patients who can benefit from valuable but limited medical resources, and determining when to advance intubated patients onto extracorporeal membrane oxygenation," they added.

 

*Age >65 years, confusion, uremia, respiration rate, blood pressure.

Source: Sci Rep 2021;11:21124

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