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Evaluation of Modified ATRIA Risk Score in Predicting Mortality in Hospitalized Patients With COVID-19
BACKGROUND: As the Modified Anticoagulation and Risk Factors in Atrial Fibrillation Risk Score (M-ATRIA-RS) encompasses prognostic risk factors of novel coronavirus-2019 (COVID-19), it may be used to predict in-hospital mortality. We aimed to investigate whether M-ATRIA-RS was an independent predict...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Southern Society for Clinical Investigation. Published by Elsevier Inc.
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8180090/ https://www.ncbi.nlm.nih.gov/pubmed/34107275 http://dx.doi.org/10.1016/j.amjms.2021.06.001 |
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author | Aciksari, Gonul Cetinkal, Gokhan Kocak, Mehmet Cag, Yasemin Atici, Adem Altunal, Lutfiye Nilsun Barman, Hasan Ali Aydin, Mehtap Kocas, Betul Balaban Cam, Gulsum Guclu, Kader Gorkem Caliskan, Mustafa |
author_facet | Aciksari, Gonul Cetinkal, Gokhan Kocak, Mehmet Cag, Yasemin Atici, Adem Altunal, Lutfiye Nilsun Barman, Hasan Ali Aydin, Mehtap Kocas, Betul Balaban Cam, Gulsum Guclu, Kader Gorkem Caliskan, Mustafa |
author_sort | Aciksari, Gonul |
collection | PubMed |
description | BACKGROUND: As the Modified Anticoagulation and Risk Factors in Atrial Fibrillation Risk Score (M-ATRIA-RS) encompasses prognostic risk factors of novel coronavirus-2019 (COVID-19), it may be used to predict in-hospital mortality. We aimed to investigate whether M-ATRIA-RS was an independent predictor of mortality in patients hospitalized for COVID-19 and compare its discrimination capability with CHADS, CHA2DS2-VASc, and modified CHA2DS2-VASc (mCHA2DS2-VASc)-RS. METHODS: A total of 1,001 patients were retrospectively analyzed and classified into three groups based on M-ATRIA-RS, designed by changing sex criteria of ATRIA-RS from female to male: Group 1 for points 0–1 (n = 448), Group 2 for points 2–4 (n = 268), and Group 3 for points ≥5 (n = 285). Clinical outcomes were defined as in-hospital mortality, need for high-flow oxygen and/or intubation, and admission to intensive care unit. RESULTS: As the M-ATRIA-RS increased, adverse clinical outcomes significantly increased (Group 1, 6.5%; Group 2, 15.3%; Group 3, 34.4%; p <0.001 mortality for in-hospital). Multivariate logistic regression analysis showed that M-ATRIA-RS, malignancy, troponin increase, and lactate dehydrogenase were independent predictors of in-hospital mortality (p<0.001, per scale possibility rate for ATRIA-RS 1.2). In receiver operating characteristic (ROC) analysis, the discriminative ability of M-ATRIA-RS was superior to mCHA2DS2-VASc-RS and ATRIA-RS, but similar to that Charlson Comorbidity Index (CCI) score (AUC(M-ATRIA)vs AUC(ATRIA) Z-test=3.14 p = 0.002, AUC(M-ATRIA)vs. AUC(mCHA2DS2-VASc) Z-test=2.14, p = 0.03; AUC(M-ATRIA)vs. AUC(CCI) Z-test=1.46 p = 0.14). CONCLUSIONS: M-ATRIA-RS is useful to predict in-hospital mortality among patients hospitalized with COVID-19. In addition, it is superior to the mCHA2DS2-VASc-RS in predicting mortality in patients with COVID-19 and is more easily calculable than the CCI score. |
format | Online Article Text |
id | pubmed-8180090 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Southern Society for Clinical Investigation. Published by Elsevier Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-81800902021-06-07 Evaluation of Modified ATRIA Risk Score in Predicting Mortality in Hospitalized Patients With COVID-19 Aciksari, Gonul Cetinkal, Gokhan Kocak, Mehmet Cag, Yasemin Atici, Adem Altunal, Lutfiye Nilsun Barman, Hasan Ali Aydin, Mehtap Kocas, Betul Balaban Cam, Gulsum Guclu, Kader Gorkem Caliskan, Mustafa Am J Med Sci Clinical Investigation BACKGROUND: As the Modified Anticoagulation and Risk Factors in Atrial Fibrillation Risk Score (M-ATRIA-RS) encompasses prognostic risk factors of novel coronavirus-2019 (COVID-19), it may be used to predict in-hospital mortality. We aimed to investigate whether M-ATRIA-RS was an independent predictor of mortality in patients hospitalized for COVID-19 and compare its discrimination capability with CHADS, CHA2DS2-VASc, and modified CHA2DS2-VASc (mCHA2DS2-VASc)-RS. METHODS: A total of 1,001 patients were retrospectively analyzed and classified into three groups based on M-ATRIA-RS, designed by changing sex criteria of ATRIA-RS from female to male: Group 1 for points 0–1 (n = 448), Group 2 for points 2–4 (n = 268), and Group 3 for points ≥5 (n = 285). Clinical outcomes were defined as in-hospital mortality, need for high-flow oxygen and/or intubation, and admission to intensive care unit. RESULTS: As the M-ATRIA-RS increased, adverse clinical outcomes significantly increased (Group 1, 6.5%; Group 2, 15.3%; Group 3, 34.4%; p <0.001 mortality for in-hospital). Multivariate logistic regression analysis showed that M-ATRIA-RS, malignancy, troponin increase, and lactate dehydrogenase were independent predictors of in-hospital mortality (p<0.001, per scale possibility rate for ATRIA-RS 1.2). In receiver operating characteristic (ROC) analysis, the discriminative ability of M-ATRIA-RS was superior to mCHA2DS2-VASc-RS and ATRIA-RS, but similar to that Charlson Comorbidity Index (CCI) score (AUC(M-ATRIA)vs AUC(ATRIA) Z-test=3.14 p = 0.002, AUC(M-ATRIA)vs. AUC(mCHA2DS2-VASc) Z-test=2.14, p = 0.03; AUC(M-ATRIA)vs. AUC(CCI) Z-test=1.46 p = 0.14). CONCLUSIONS: M-ATRIA-RS is useful to predict in-hospital mortality among patients hospitalized with COVID-19. In addition, it is superior to the mCHA2DS2-VASc-RS in predicting mortality in patients with COVID-19 and is more easily calculable than the CCI score. Southern Society for Clinical Investigation. Published by Elsevier Inc. 2021-12 2021-06-06 /pmc/articles/PMC8180090/ /pubmed/34107275 http://dx.doi.org/10.1016/j.amjms.2021.06.001 Text en © 2021 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active. |
spellingShingle | Clinical Investigation Aciksari, Gonul Cetinkal, Gokhan Kocak, Mehmet Cag, Yasemin Atici, Adem Altunal, Lutfiye Nilsun Barman, Hasan Ali Aydin, Mehtap Kocas, Betul Balaban Cam, Gulsum Guclu, Kader Gorkem Caliskan, Mustafa Evaluation of Modified ATRIA Risk Score in Predicting Mortality in Hospitalized Patients With COVID-19 |
title | Evaluation of Modified ATRIA Risk Score in Predicting Mortality in Hospitalized Patients With COVID-19 |
title_full | Evaluation of Modified ATRIA Risk Score in Predicting Mortality in Hospitalized Patients With COVID-19 |
title_fullStr | Evaluation of Modified ATRIA Risk Score in Predicting Mortality in Hospitalized Patients With COVID-19 |
title_full_unstemmed | Evaluation of Modified ATRIA Risk Score in Predicting Mortality in Hospitalized Patients With COVID-19 |
title_short | Evaluation of Modified ATRIA Risk Score in Predicting Mortality in Hospitalized Patients With COVID-19 |
title_sort | evaluation of modified atria risk score in predicting mortality in hospitalized patients with covid-19 |
topic | Clinical Investigation |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8180090/ https://www.ncbi.nlm.nih.gov/pubmed/34107275 http://dx.doi.org/10.1016/j.amjms.2021.06.001 |
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