Background Already at hospital admission, clinicians require simple tools to identify hospitalized COVID-19 patients at high risk of mortality. Such tools can significantly improve resource allocation and patient management within hospitals. From the statistical point of view, extended time-to-event models are required to account for competing risks (discharge from hospital) and censoring so that active cases can also contribute to the analysis. Methods We used the hospital-based open Khorshid COVID Cohort (KCC) study with 630 COVID-19 patients from Isfahan, Iran. Competing risk methods are used to develop a death risk chart based on the following variables, which can simply be measured at hospital admission: sex, age, hypertension, oxygen saturation, and Charlson Comorbidity Index. The area under the receiver operator curve was used to assess accuracy concerning discrimination between patients discharged alive and dead. Results Cause-specific hazard regression models show that these baseline variables are associated with both death, and discharge hazards. The risk chart reflects the combined results of the two cause-specific hazard regression models. The proposed risk assessment method had a very good accuracy (AUC = 0.872 [CI 95%: 0.835–0.910]). Conclusions This study aims to improve and validate a personalized mortality risk calculator based on hospitalized COVID-19 patients. The risk assessment of patient mortality provides physicians with additional guidance for making tough decisions.
【저자키워드】 COVID-19, Mortality, Prognosis, Risk assessment, Cause-specific hazard regression, Risk chart, 【초록키워드】 hospital, Sex, risk, hypertension, discharge, hospitals, COVID, oxygen saturation, Iran, Accuracy, Regression model, management, Patient, death, age, Hospital admission, resource, Guidance, hospitalized COVID-19 patient, mortality risk, Analysis, COVID-19 patient, high risk, hospitalized COVID-19 patients, clinician, Charlson Comorbidity Index, physician, regression models, operator, dead, patient mortality, variable, hazards, statistical, IMPROVE, Result, identify, was used, develop, significantly, required, provide, contribute, discharged, competing, concerning, reflect, baseline, calculator, Khorshid, variables, 【제목키워드】 COVID, mortality risk, Khorshid,