Predicting mortality of individual patients with COVID-19: a multicentre Dutch cohort

Objective Develop and validate models that predict mortality of patients diagnosed with COVID-19 admitted to the hospital.Design Retrospective cohort study.Setting A multicentre cohort across 10 Dutch hospitals including patients from 27 February to 8 June 2020.Participants SARS-CoV-2 positive patients (age ≥18) admitted to the hospital.Main outcome measures 21-day all-cause mortality evaluated by the area under the receiver operator curve (AUC), sensitivity, specificity, positive predictive value and negative predictive value. The predictive value of age was explored by comparison with age-ba... Mehr ...

Verfasser: Henk A Marquering
Dan Piña-Fuentes
Martijn Beudel
Iwan C C van der Horst
Auke C Reidinga
Roger J M W Rennenberg
Martijn D de Kruif
Marcus L F Janssen
Marcel J H Aries
Suat Simsek
Joop P van den Bergh
Lucas A Ramos
Paul W G Elbers
W Joost Wiersinga
Maarten C Ottenhoff
Wouter Potters
Deborah Hubers
Shi Hu
Egill A Fridgeirsson
Rajat Thomas
Christian Herff
Pieter Kubben
Max Welling
Lucas M Fleuren
Michiel Schinkel
Peter G Noordzij
Caroline E Wyers
David T B Buis
Ella H C van den Hout
Daisy Rusch
Kim C E Sigaloff
Renee A Douma
Lianne de Haan
Niels C Gritters van den Oever
Guido A van Wingen
Dokumenttyp: Artikel
Erscheinungsdatum: 2021
Reihe/Periodikum: BMJ Open, Vol 11, Iss 7 (2021)
Verlag/Hrsg.: BMJ Publishing Group
Schlagwörter: Medicine / R
Sprache: Englisch
Permalink: https://search.fid-benelux.de/Record/base-26627051
Datenquelle: BASE; Originalkatalog
Powered By: BASE
Link(s) : https://doi.org/10.1136/bmjopen-2020-047347

Objective Develop and validate models that predict mortality of patients diagnosed with COVID-19 admitted to the hospital.Design Retrospective cohort study.Setting A multicentre cohort across 10 Dutch hospitals including patients from 27 February to 8 June 2020.Participants SARS-CoV-2 positive patients (age ≥18) admitted to the hospital.Main outcome measures 21-day all-cause mortality evaluated by the area under the receiver operator curve (AUC), sensitivity, specificity, positive predictive value and negative predictive value. The predictive value of age was explored by comparison with age-based rules used in practice and by excluding age from the analysis.Results 2273 patients were included, of whom 516 had died or discharged to palliative care within 21 days after admission. Five feature sets, including premorbid, clinical presentation and laboratory and radiology values, were derived from 80 features. Additionally, an Analysis of Variance (ANOVA)-based data-driven feature selection selected the 10 features with the highest F values: age, number of home medications, urea nitrogen, lactate dehydrogenase, albumin, oxygen saturation (%), oxygen saturation is measured on room air, oxygen saturation is measured on oxygen therapy, blood gas pH and history of chronic cardiac disease. A linear logistic regression and non-linear tree-based gradient boosting algorithm fitted the data with an AUC of 0.81 (95% CI 0.77 to 0.85) and 0.82 (0.79 to 0.85), respectively, using the 10 selected features. Both models outperformed age-based decision rules used in practice (AUC of 0.69, 0.65 to 0.74 for age >70). Furthermore, performance remained stable when excluding age as predictor (AUC of 0.78, 0.75 to 0.81).Conclusion Both models showed good performance and had better test characteristics than age-based decision rules, using 10 admission features readily available in Dutch hospitals. The models hold promise to aid decision-making during a hospital bed shortage.