Open AccessDevelopment and validation of a predictive model of in-hospital mortality in COVID-19 patients
Author(s) -
Diego Velasco-Rodríguez,
Juan-Manuel Alonso-Domínguez,
Rosa Vidal Laso,
Daniel LáinezGonzález,
Aránzazu GarcíaRaso,
Sara MartínHerrero,
Antonio Herrero,
Inés Martínez Alfonzo,
Juana SerranoLópez,
Elena Jiménez-Barral,
Sara Nistal,
María Dolores Benítez Márquez,
Elham Askari,
Jorge Castillo Álvarez,
A. Gil Núñez,
Á. Jiménez Rodríguez,
Sarah Heili-Frades,
César Pérez–Calvo,
Miguel Górgolas,
Raquel Barba,
Pilar Llamas-Sillero
Publication year - 2021
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0247676
Subject(s) - medicine , logistic regression , diabetes mellitus , odds ratio , predictive value of tests , gastroenterology , endocrinology
We retrospectively evaluated 2879 hospitalized COVID-19 patients from four hospitals to evaluate the ability of demographic data, medical history, and on-admission laboratory parameters to predict in-hospital mortality. Association of previously published risk factors (age, gender, arterial hypertension, diabetes mellitus, smoking habit, obesity, renal failure, cardiovascular/ pulmonary diseases, serum ferritin, lymphocyte count, APTT, PT, fibrinogen, D-dimer, and platelet count) with death was tested by a multivariate logistic regression, and a predictive model was created, with further validation in an independent sample. A total of 2070 hospitalized COVID-19 patients were finally included in the multivariable analysis. Age 61–70 years ( p <0.001; OR: 7.69; 95%CI: 2.93 to 20.14), age 71–80 years ( p <0.001; OR: 14.99; 95%CI: 5.88 to 38.22), age >80 years ( p <0.001; OR: 36.78; 95%CI: 14.42 to 93.85), male gender ( p <0.001; OR: 1.84; 95%CI: 1.31 to 2.58), D-dimer levels >2 ULN ( p = 0.003; OR: 1.79; 95%CI: 1.22 to 2.62), and prolonged PT ( p <0.001; OR: 2.18; 95%CI: 1.49 to 3.18) were independently associated with increased in-hospital mortality. A predictive model performed with these parameters showed an AUC of 0.81 in the development cohort (n = 1270) [sensitivity of 95.83%, specificity of 41.46%, negative predictive value of 98.01%, and positive predictive value of 24.85%]. These results were then validated in an independent data sample (n = 800). Our predictive model of in-hospital mortality of COVID-19 patients has been developed, calibrated and validated. The model (MRS-COVID) included age, male gender, and on-admission coagulopathy markers as positively correlated factors with fatal outcome.