Absolute Mortality Risk Assessment of Covid-19 Patients: The Khorshid Covid Cohort (Kcc) Study Publisher Pubmed



Marateb HR^{1, 2} ; Von Cube M³ ; Sami R⁴ ; Haghjooy Javanmard S⁵ ; Mansourian M^{2, 6} ; Amra B⁷ ; Soltaninejad F⁸ ; Mortazavi M⁹ ; Adibi P¹⁰ ; Khademi N¹¹ ; Sadat Hosseini N¹¹ ; Toghyani A¹¹ ; Hassannejad R¹² ; Mananas MA^{2, 13} Show All Authors Show Affiliations
Source: BMC Medical Research Methodology Published:2021

Abstract

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. © 2021, The Author(s).