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External Validation of COVID-19 Risk Scores during Three Waves of Pandemic in a German Cohort—A Retrospective Study
Several risk scores were developed during the COVID-19 pandemic to identify patients at risk for critical illness as a basic step to personalizing medicine even in pandemic circumstances. However, the generalizability of these scores with regard to different populations, clinical settings, healthcar...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9693591/ https://www.ncbi.nlm.nih.gov/pubmed/36579493 http://dx.doi.org/10.3390/jpm12111775 |
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author | Häger, Lukas Wendland, Philipp Biergans, Stephanie Lederer, Simone de Arruda Botelho Herr, Marius Erhardt, Christian Schmauder, Kristina Kschischo, Maik Malek, Nisar Peter Bunk, Stefanie Bitzer, Michael Gladstone, Beryl Primrose Göpel, Siri |
author_facet | Häger, Lukas Wendland, Philipp Biergans, Stephanie Lederer, Simone de Arruda Botelho Herr, Marius Erhardt, Christian Schmauder, Kristina Kschischo, Maik Malek, Nisar Peter Bunk, Stefanie Bitzer, Michael Gladstone, Beryl Primrose Göpel, Siri |
author_sort | Häger, Lukas |
collection | PubMed |
description | Several risk scores were developed during the COVID-19 pandemic to identify patients at risk for critical illness as a basic step to personalizing medicine even in pandemic circumstances. However, the generalizability of these scores with regard to different populations, clinical settings, healthcare systems, and new epidemiological circumstances is unknown. The aim of our study was to compare the predictive validity of qSOFA, CRB65, NEWS, COVID-GRAM, and 4C-Mortality score. In a monocentric retrospective cohort, consecutively hospitalized adults with COVID-19 from February 2020 to June 2021 were included; risk scores at admission were calculated. The area under the receiver operating characteristic curve and the area under the precision–recall curve were compared using DeLong’s method and a bootstrapping approach. A total of 347 patients were included; 23.6% were admitted to the ICU, and 9.2% died in a hospital. NEWS and 4C-Score performed best for the outcomes ICU admission and in-hospital mortality. The easy-to-use bedside score NEWS has proven to identify patients at risk for critical illness, whereas the more complex COVID-19-specific scores 4C and COVID-GRAM were not superior. Decreasing mortality and ICU-admission rates affected the discriminatory ability of all scores. A further evaluation of risk assessment is needed in view of new and rapidly changing epidemiological evolution. |
format | Online Article Text |
id | pubmed-9693591 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-96935912022-11-26 External Validation of COVID-19 Risk Scores during Three Waves of Pandemic in a German Cohort—A Retrospective Study Häger, Lukas Wendland, Philipp Biergans, Stephanie Lederer, Simone de Arruda Botelho Herr, Marius Erhardt, Christian Schmauder, Kristina Kschischo, Maik Malek, Nisar Peter Bunk, Stefanie Bitzer, Michael Gladstone, Beryl Primrose Göpel, Siri J Pers Med Article Several risk scores were developed during the COVID-19 pandemic to identify patients at risk for critical illness as a basic step to personalizing medicine even in pandemic circumstances. However, the generalizability of these scores with regard to different populations, clinical settings, healthcare systems, and new epidemiological circumstances is unknown. The aim of our study was to compare the predictive validity of qSOFA, CRB65, NEWS, COVID-GRAM, and 4C-Mortality score. In a monocentric retrospective cohort, consecutively hospitalized adults with COVID-19 from February 2020 to June 2021 were included; risk scores at admission were calculated. The area under the receiver operating characteristic curve and the area under the precision–recall curve were compared using DeLong’s method and a bootstrapping approach. A total of 347 patients were included; 23.6% were admitted to the ICU, and 9.2% died in a hospital. NEWS and 4C-Score performed best for the outcomes ICU admission and in-hospital mortality. The easy-to-use bedside score NEWS has proven to identify patients at risk for critical illness, whereas the more complex COVID-19-specific scores 4C and COVID-GRAM were not superior. Decreasing mortality and ICU-admission rates affected the discriminatory ability of all scores. A further evaluation of risk assessment is needed in view of new and rapidly changing epidemiological evolution. MDPI 2022-10-28 /pmc/articles/PMC9693591/ /pubmed/36579493 http://dx.doi.org/10.3390/jpm12111775 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Häger, Lukas Wendland, Philipp Biergans, Stephanie Lederer, Simone de Arruda Botelho Herr, Marius Erhardt, Christian Schmauder, Kristina Kschischo, Maik Malek, Nisar Peter Bunk, Stefanie Bitzer, Michael Gladstone, Beryl Primrose Göpel, Siri External Validation of COVID-19 Risk Scores during Three Waves of Pandemic in a German Cohort—A Retrospective Study |
title | External Validation of COVID-19 Risk Scores during Three Waves of Pandemic in a German Cohort—A Retrospective Study |
title_full | External Validation of COVID-19 Risk Scores during Three Waves of Pandemic in a German Cohort—A Retrospective Study |
title_fullStr | External Validation of COVID-19 Risk Scores during Three Waves of Pandemic in a German Cohort—A Retrospective Study |
title_full_unstemmed | External Validation of COVID-19 Risk Scores during Three Waves of Pandemic in a German Cohort—A Retrospective Study |
title_short | External Validation of COVID-19 Risk Scores during Three Waves of Pandemic in a German Cohort—A Retrospective Study |
title_sort | external validation of covid-19 risk scores during three waves of pandemic in a german cohort—a retrospective study |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9693591/ https://www.ncbi.nlm.nih.gov/pubmed/36579493 http://dx.doi.org/10.3390/jpm12111775 |
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