External validation of the 4C mortality score among COVID-19 patients admitted to hospital in Ontario, Canada: a retrospective study

Abstract Risk prediction scores are important tools to support clinical decision-making for patients with coronavirus disease (COVID-19). The objective of this paper was to validate the 4C mortality score, originally developed in the United Kingdom, for a Canadian population, and to examine its perf...

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Autores principales:	Aaron Jones, Tyler Pitre, Mats Junek, Jessica Kapralik, Rina Patel, Edward Feng, Laura Dawson, Jennifer L. Y. Tsang, MyLinh Duong, Terence Ho, Marla K. Beauchamp, Andrew P. Costa, Rebecca Kruisselbrink, the COREG Investigators
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/30497207b4ac453e84fa1227cc75c841
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spelling	oai:doaj.org-article:30497207b4ac453e84fa1227cc75c8412021-12-02T18:14:39ZExternal validation of the 4C mortality score among COVID-19 patients admitted to hospital in Ontario, Canada: a retrospective study10.1038/s41598-021-97332-12045-2322https://doaj.org/article/30497207b4ac453e84fa1227cc75c8412021-09-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-97332-1https://doaj.org/toc/2045-2322Abstract Risk prediction scores are important tools to support clinical decision-making for patients with coronavirus disease (COVID-19). The objective of this paper was to validate the 4C mortality score, originally developed in the United Kingdom, for a Canadian population, and to examine its performance over time. We conducted an external validation study within a registry of COVID-19 positive hospital admissions in the Kitchener-Waterloo and Hamilton regions of southern Ontario between March 4, 2020 and June 13, 2021. We examined the validity of the 4C score to prognosticate in-hospital mortality using the area under the receiver operating characteristic curve (AUC) with 95% confidence intervals calculated via bootstrapping. The study included 959 individuals, of whom 224 (23.4%) died in-hospital. Median age was 72 years and 524 individuals (55%) were male. The AUC of the 4C score was 0.77, 95% confidence interval 0.79–0.87. Overall mortality rates across the pre-defined risk groups were 0% (Low), 8.0% (Intermediate), 27.2% (High), and 54.2% (Very High). Wave 1, 2 and 3 values of the AUC were 0.81 (0.76, 0.86), 0.74 (0.69, 0.80), and 0.76 (0.69, 0.83) respectively. The 4C score is a valid tool to prognosticate mortality from COVID-19 in Canadian hospitals and can be used to prioritize care and resources for patients at greatest risk of death.Aaron JonesTyler PitreMats JunekJessica KapralikRina PatelEdward FengLaura DawsonJennifer L. Y. TsangMyLinh DuongTerence HoMarla K. BeauchampAndrew P. CostaRebecca Kruisselbrinkthe COREG InvestigatorsNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-7 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Aaron Jones Tyler Pitre Mats Junek Jessica Kapralik Rina Patel Edward Feng Laura Dawson Jennifer L. Y. Tsang MyLinh Duong Terence Ho Marla K. Beauchamp Andrew P. Costa Rebecca Kruisselbrink the COREG Investigators External validation of the 4C mortality score among COVID-19 patients admitted to hospital in Ontario, Canada: a retrospective study
description	Abstract Risk prediction scores are important tools to support clinical decision-making for patients with coronavirus disease (COVID-19). The objective of this paper was to validate the 4C mortality score, originally developed in the United Kingdom, for a Canadian population, and to examine its performance over time. We conducted an external validation study within a registry of COVID-19 positive hospital admissions in the Kitchener-Waterloo and Hamilton regions of southern Ontario between March 4, 2020 and June 13, 2021. We examined the validity of the 4C score to prognosticate in-hospital mortality using the area under the receiver operating characteristic curve (AUC) with 95% confidence intervals calculated via bootstrapping. The study included 959 individuals, of whom 224 (23.4%) died in-hospital. Median age was 72 years and 524 individuals (55%) were male. The AUC of the 4C score was 0.77, 95% confidence interval 0.79–0.87. Overall mortality rates across the pre-defined risk groups were 0% (Low), 8.0% (Intermediate), 27.2% (High), and 54.2% (Very High). Wave 1, 2 and 3 values of the AUC were 0.81 (0.76, 0.86), 0.74 (0.69, 0.80), and 0.76 (0.69, 0.83) respectively. The 4C score is a valid tool to prognosticate mortality from COVID-19 in Canadian hospitals and can be used to prioritize care and resources for patients at greatest risk of death.
format	article
author	Aaron Jones Tyler Pitre Mats Junek Jessica Kapralik Rina Patel Edward Feng Laura Dawson Jennifer L. Y. Tsang MyLinh Duong Terence Ho Marla K. Beauchamp Andrew P. Costa Rebecca Kruisselbrink the COREG Investigators
author_facet	Aaron Jones Tyler Pitre Mats Junek Jessica Kapralik Rina Patel Edward Feng Laura Dawson Jennifer L. Y. Tsang MyLinh Duong Terence Ho Marla K. Beauchamp Andrew P. Costa Rebecca Kruisselbrink the COREG Investigators
author_sort	Aaron Jones
title	External validation of the 4C mortality score among COVID-19 patients admitted to hospital in Ontario, Canada: a retrospective study
title_short	External validation of the 4C mortality score among COVID-19 patients admitted to hospital in Ontario, Canada: a retrospective study
title_full	External validation of the 4C mortality score among COVID-19 patients admitted to hospital in Ontario, Canada: a retrospective study
title_fullStr	External validation of the 4C mortality score among COVID-19 patients admitted to hospital in Ontario, Canada: a retrospective study
title_full_unstemmed	External validation of the 4C mortality score among COVID-19 patients admitted to hospital in Ontario, Canada: a retrospective study
title_sort	external validation of the 4c mortality score among covid-19 patients admitted to hospital in ontario, canada: a retrospective study
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/30497207b4ac453e84fa1227cc75c841
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External validation of the 4C mortality score among COVID-19 patients admitted to hospital in Ontario, Canada: a retrospective study

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