RT Journal Article
T1 Death risk stratification in elderly patients with covid-19. A comparative cohort study in nursing homes outbreaks.
A1 Bernabeu-Wittel, M
A1 Ternero-Vega, J E
A1 Díaz-Jiménez, P
A1 Conde-Guzmán, C
A1 Nieto-Martín, M D
A1 Moreno-Gaviño, L
A1 Delgado-Cuesta, J
A1 Rincón-Gómez, M
A1 Giménez-Miranda, L
A1 Navarro-Amuedo, M D
A1 Muñoz-García, M M
A1 Calzón-Fernández, S
A1 Ollero-Baturone, M
K1 COVID-19
K1 CURB-65
K1 Death-risk
K1 Multimorbidity
K1 PROFUND
AB Elderly people are more severely affected by COVID-19. Nevertheless scarce information about specific prognostic scores for this population is available. The main objective was to compare the accuracy of recently developed COVID-19 prognostic scores to that of CURB-65, Charlson and PROFUND indices in a cohort of 272 elderly patients from four nursing homes, affected by COVID-19. Accuracy was measured by calibration (calibration curves and Hosmer-Lemeshov (H-L) test), and discriminative power (area under the receiver operation curve (AUC-ROC). Negative and positive predictive values (NPV and PPV) were also obtained. Overall mortality rate was 22.4 %. Only ACP and Shi et al. out of 10 specific COVID-19 indices could be assessed. All indices but CURB-65 showed a good calibration by H-L test, whilst PROFUND, ACP and CURB-65 showed best results in calibration curves. Only CURB-65 (AUC-ROC = 0.81 [0.75-0.87])) and PROFUND (AUC-ROC = 0.67 [0.6-0.75])) showed good discrimination power. The highest NPV was obtained by CURB-65 (95 % [90-98%]), PROFUND (93 % [77-98%]), and their combination (100 % [82-100%]); whereas CURB-65 (74 % [51-88%]), and its combination with PROFUND (80 % [50-94%]) showed highest PPV. PROFUND and CURB-65 indices showed the highest accuracy in predicting death-risk of elderly patients affected by COVID-19, whereas Charlson and recent developed COVID-19 specific tools lacked it, or were not available to assess. A comprehensive clinical stratification on two-level basis (basal death risk due to chronic conditions by PROFUND index, plus current death risk due to COVID-19 by CURB-65), could be an appropriate approach.
YR 2020
FD 2020-08-25
LK http://hdl.handle.net/10668/16194
UL http://hdl.handle.net/10668/16194
LA en
DS RISalud
RD Apr 16, 2025