Objective: Coronavirus disease 2019 (COVID-19) is a disease with a high rate of progression to critical illness. However, the stratification of patients at risk of mortality is not well defined. In this study, we aimed to define a mortality risk index to allocate patients to the appropriate intensity of care. Methods: This is a 12 months observational longitudinal study designed to develop and validate a pragmatic mortality risk score to stratify COVID-19 patients aged ≥18 years and admitted to hospital between March 2020 and March 2021. Main outcome was in-hospital mortality. Results: 244 patients were included in the study (mortality rate 29.9%). The Covid-19 Assessment for Survival at Admission (CASA) index included seven variables readily available at admission: respiratory rate, troponin, albumin, CKD-EPI, white blood cell count, D-dimer, Pa02/Fi02. The CASA index showed high discrimination for mortality with an AUC of 0.91 (sensitivity 98.6%; specificity 69%) and a better performance compared to SOFA (AUC = 0.76), age (AUC = 0.76) and 4C mortality (AUC = 0.82). The cut-off identified (11.994) for CASA index showed a negative predictive value of 99.16% and a positive predictive value of 57.58%. Conclusions: A quick and readily available index has been identified to help clinicians stratify COVID-19 patients according to the appropriate intensity of care and minimize hospital admission to patients at high risk of mortality.
【저자키워드】 COVID-19, mortality risk, outcome research, stratification index, systemic score, 【초록키워드】 Stratification, Coronavirus disease 2019, Mortality, hospital, risk, D-dimer, progression, outcome, sensitivity, specificity, Positive predictive value, White blood cell, Patient, albumin, age, SOFA, Hospital admission, mortality rate, assessment, disease, Care, Critical, in-hospital mortality, Pragmatic, COVID-19 patient, Negative predictive value, AUC, respiratory rate, high risk, intensity, clinician, help, cut-off, variable, Seven, defined, develop, to define, 【제목키워드】 assessment, Month,