Dataset Information

A Model Predicting Mortality of Hospitalized Covid-19 Patients Four Days After Admission: Development, Internal and Temporal-External Validation.

ABSTRACT:

Objective

To develop and validate a prognostic model for in-hospital mortality after four days based on age, fever at admission and five haematological parameters routinely measured in hospitalized Covid-19 patients during the first four days after admission.

Methods

Haematological parameters measured during the first 4 days after admission were subjected to a linear mixed model to obtain patient-specific intercepts and slopes for each parameter. A prediction model was built using logistic regression with variable selection and shrinkage factor estimation supported by bootstrapping. Model development was based on 481 survivors and 97 non-survivors, hospitalized before the occurrence of mutations. Internal validation was done by 10-fold cross-validation. The model was temporally-externally validated in 299 survivors and 42 non-survivors hospitalized when the Alpha variant (B.1.1.7) was prevalent.

Results

The final model included age, fever on admission as well as the slope or intercept of lactate dehydrogenase, platelet count, C-reactive protein, and creatinine. Tenfold cross validation resulted in a mean area under the receiver operating characteristic curve (AUROC) of 0.92, a mean calibration slope of 1.0023 and a Brier score of 0.076. At temporal-external validation, application of the previously developed model showed an AUROC of 0.88, a calibration slope of 0.95 and a Brier score of 0.073. Regarding the relative importance of the variables, the (apparent) variation in mortality explained by the six variables deduced from the haematological parameters measured during the first four days is higher (explained variation 0.295) than that of age (0.210).

Conclusions

The presented model requires only variables routinely acquired in hospitals, which allows immediate and wide-spread use as a decision support for earlier discharge of low-risk patients to reduce the burden on the health care system.

Clinical trial registration

Austrian Coronavirus Adaptive Clinical Trial (ACOVACT); ClinicalTrials.gov, identifier NCT04351724.

SUBMITTER: Heber S

PROVIDER: S-EPMC8819729 | biostudies-literature | 2021

REPOSITORIES: biostudies-literature

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Publications

A Model Predicting Mortality of Hospitalized Covid-19 Patients Four Days After Admission: Development, Internal and Temporal-External Validation.

Heber Stefan S Pereyra David D Schrottmaier Waltraud C WC Kammerer Kerstin K Santol Jonas J Rumpf Benedikt B Pawelka Erich E Hanna Markus M Scholz Alexander A Liu Markus M Hell Agnes A Heiplik Klara K Lickefett Benno B Havervall Sebastian S Traugott Marianna T MT Neuböck Matthias J MJ Schörgenhofer Christian C Seitz Tamara T Firbas Christa C Karolyi Mario M Weiss Günter G Jilma Bernd B Thålin Charlotte C Bellmann-Weiler Rosa R Salzer Helmut J F HJF Szepannek Gero G Fischer Michael J M MJM Zoufaly Alexander A Gleiss Andreas A Assinger Alice A

Frontiers in cellular and infection microbiology 20220124

<h4>Objective</h4>To develop and validate a prognostic model for in-hospital mortality after four days based on age, fever at admission and five haematological parameters routinely measured in hospitalized Covid-19 patients during the first four days after admission.<h4>Methods</h4>Haematological parameters measured during the first 4 days after admission were subjected to a linear mixed model to obtain patient-specific intercepts and slopes for each parameter. A prediction model was built using ...[more]

PMID: 35141170

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Dataset Information

A Model Predicting Mortality of Hospitalized Covid-19 Patients Four Days After Admission: Development, Internal and Temporal-External Validation.

Objective

Methods

Results

Conclusions

Clinical trial registration

Publications

A Model Predicting Mortality of Hospitalized Covid-19 Patients Four Days After Admission: Development, Internal and Temporal-External Validation.

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