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Validating the RISE UP score for predicting prognosis in patients with COVID-19 in the emergency department: a retrospective study

OBJECTIVE: To mitigate the burden of COVID-19 on the healthcare system, information on the prognosis of the disease is needed. The recently developed Risk Stratification in the Emergency Department in Acutely ill Older Patients (RISE UP) score has very good discriminatory value for short-term mortal...

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Autores principales: van Dam, Paul MEL, Zelis, Noortje, Stassen, Patricia, van Twist, Daan J L, De Leeuw, Peter W, van Kuijk, Sander, Buijs, Jacqueline
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7925864/
https://www.ncbi.nlm.nih.gov/pubmed/33550267
http://dx.doi.org/10.1136/bmjopen-2020-045141
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author van Dam, Paul MEL
Zelis, Noortje
Stassen, Patricia
van Twist, Daan J L
De Leeuw, Peter W
van Kuijk, Sander
Buijs, Jacqueline
author_facet van Dam, Paul MEL
Zelis, Noortje
Stassen, Patricia
van Twist, Daan J L
De Leeuw, Peter W
van Kuijk, Sander
Buijs, Jacqueline
author_sort van Dam, Paul MEL
collection PubMed
description OBJECTIVE: To mitigate the burden of COVID-19 on the healthcare system, information on the prognosis of the disease is needed. The recently developed Risk Stratification in the Emergency Department in Acutely ill Older Patients (RISE UP) score has very good discriminatory value for short-term mortality in older patients in the emergency department (ED). It consists of six readily available items. We hypothesised that the RISE UP score could have discriminatory value for 30-day mortality in ED patients with COVID-19. DESIGN: Retrospective analysis. SETTING: Two EDs of the Zuyderland Medical Centre, secondary care hospital in the Netherlands. PARTICIPANTS: The study sample consisted of 642 adult ED patients diagnosed with COVID-19 between 3 March and until 25 May 2020. Inclusion criteria were (1) admission to the hospital with symptoms suggestive of COVID-19 and (2) positive result of the PCR or (very) high suspicion of COVID-19 according to the chest CT scan. OUTCOME: Primary outcome was 30-day mortality, secondary outcome was a composite of 30-day mortality and admission to intensive care unit (ICU). RESULTS: Within 30 days after presentation, 167 patients (26.0%) died and 102 patients (15.9%) were admitted to ICU. The RISE UP score showed good discriminatory value for 30-day mortality (area under the receiver operating characteristic curve (AUC) 0.77, 95% CI 0.73 to 0.81) and for the composite outcome (AUC 0.72, 95% CI 0.68 to 0.76). Patients with RISE UP scores below 10% (n=121) had favourable outcome (zero deaths and six ICU admissions), while those with scores above 30% (n=221) were at high risk of adverse outcome (46.6% mortality and 19.0% ICU admissions). CONCLUSION: The RISE UP score is an accurate prognostic model for adverse outcome in ED patients with COVID-19. It can be used to identify patients at risk of short-term adverse outcome and may help guide decision-making and allocating healthcare resources.
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spelling pubmed-79258642021-03-19 Validating the RISE UP score for predicting prognosis in patients with COVID-19 in the emergency department: a retrospective study van Dam, Paul MEL Zelis, Noortje Stassen, Patricia van Twist, Daan J L De Leeuw, Peter W van Kuijk, Sander Buijs, Jacqueline BMJ Open Infectious Diseases OBJECTIVE: To mitigate the burden of COVID-19 on the healthcare system, information on the prognosis of the disease is needed. The recently developed Risk Stratification in the Emergency Department in Acutely ill Older Patients (RISE UP) score has very good discriminatory value for short-term mortality in older patients in the emergency department (ED). It consists of six readily available items. We hypothesised that the RISE UP score could have discriminatory value for 30-day mortality in ED patients with COVID-19. DESIGN: Retrospective analysis. SETTING: Two EDs of the Zuyderland Medical Centre, secondary care hospital in the Netherlands. PARTICIPANTS: The study sample consisted of 642 adult ED patients diagnosed with COVID-19 between 3 March and until 25 May 2020. Inclusion criteria were (1) admission to the hospital with symptoms suggestive of COVID-19 and (2) positive result of the PCR or (very) high suspicion of COVID-19 according to the chest CT scan. OUTCOME: Primary outcome was 30-day mortality, secondary outcome was a composite of 30-day mortality and admission to intensive care unit (ICU). RESULTS: Within 30 days after presentation, 167 patients (26.0%) died and 102 patients (15.9%) were admitted to ICU. The RISE UP score showed good discriminatory value for 30-day mortality (area under the receiver operating characteristic curve (AUC) 0.77, 95% CI 0.73 to 0.81) and for the composite outcome (AUC 0.72, 95% CI 0.68 to 0.76). Patients with RISE UP scores below 10% (n=121) had favourable outcome (zero deaths and six ICU admissions), while those with scores above 30% (n=221) were at high risk of adverse outcome (46.6% mortality and 19.0% ICU admissions). CONCLUSION: The RISE UP score is an accurate prognostic model for adverse outcome in ED patients with COVID-19. It can be used to identify patients at risk of short-term adverse outcome and may help guide decision-making and allocating healthcare resources. BMJ Publishing Group 2021-02-05 /pmc/articles/PMC7925864/ /pubmed/33550267 http://dx.doi.org/10.1136/bmjopen-2020-045141 Text en © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/ http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle Infectious Diseases
van Dam, Paul MEL
Zelis, Noortje
Stassen, Patricia
van Twist, Daan J L
De Leeuw, Peter W
van Kuijk, Sander
Buijs, Jacqueline
Validating the RISE UP score for predicting prognosis in patients with COVID-19 in the emergency department: a retrospective study
title Validating the RISE UP score for predicting prognosis in patients with COVID-19 in the emergency department: a retrospective study
title_full Validating the RISE UP score for predicting prognosis in patients with COVID-19 in the emergency department: a retrospective study
title_fullStr Validating the RISE UP score for predicting prognosis in patients with COVID-19 in the emergency department: a retrospective study
title_full_unstemmed Validating the RISE UP score for predicting prognosis in patients with COVID-19 in the emergency department: a retrospective study
title_short Validating the RISE UP score for predicting prognosis in patients with COVID-19 in the emergency department: a retrospective study
title_sort validating the rise up score for predicting prognosis in patients with covid-19 in the emergency department: a retrospective study
topic Infectious Diseases
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7925864/
https://www.ncbi.nlm.nih.gov/pubmed/33550267
http://dx.doi.org/10.1136/bmjopen-2020-045141
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