Journal of Emergency Practice and Trauma

Prognostic value of intensive care scores concerning the prediction of 30-day mortality in COVID-19

Document Type : Original Article

Authors

Navid Kalani 1
Masoud Tavasolian 2
Khaterh Dehghani 1
Seyed Reza Mousavi 3
Erfan Ghanbarzadeh 4
Masihallah Shakeri 1
Elahe Rahmanian 1
Poorya Aryanpoor 2
Naser Hatami 2
Zhila Rahmanian 1
Samaneh Abiri 1

1 Research Center for Non-communicable Diseases, Jahrom University of Medical Sciences, Jahrom, Iran

2 Student Research Committee, Jahrom University of Medical Sciences, Jahrom, Iran

3 Department of Neurosurgery, School of Medicine, Chamran Hospital, Namazi Teaching Hospital, Shiraz University of Medical Science, Iran

4 Student Research Committee, Guilan University of Medical Sciences, Rasht, Iran

https://doi.org/10.34172/jept.2022.28
Abstract
Objective: The goal of our study was to determine the prognostic value of CURB-65,
Sequential Organ Failure Assessment (SOFA), pneumonia severity index (PSI), MuLBSTA,
and Acute Physiology and Chronic Health Evaluation (APACHE) II upon admission in
patients with coronavirus disease 2019 (COVID-19, as well as the prediction cut-off value
for death regarding these parameters.
Methods: This observational retrospective study was performed in COVID-19 triage
in Peymaniyeh hospital in Jahrom in 2021. In order to calculate SOFA, APACHE II, PSI,
MuLBSTA, and CURB-65, data were collected from patients who were selected by available
sampling method from PCR-confirmed COVID-19 patients. Thirty-day mortality was
assessed as the primary outcome. ROC analysis was conducted using the STATA software to
evaluate the prognostic value of the scoring systems. DeLong test was utilized to compare
AUC of scores using a web based tool.
Results:Ninety-two patients were included in this study with the mean age of 51.02±17.81
years (male to female ratio was 1:1). SOFA had an AUC of 0.656 (P=0.130), but other indices
had statistically significant values of AUC. Based on the comparison of the AUCs, SOFA
was the worst scoring system in COVID-19 as it had significantly lower AUC than PSI and
APACHE II (P<0.05); while its comparison with MULBSTA and CURB65 was not statistically
significant (P>0.05).
Conclusion: It seems that APACHE II and PSI are the best prognostic factors in our study
with no statistical difference compared together (P>0.05). The sensitivity of APACHE II and
PSI was 0.857 with the specificity of 0.927 and 0.976, respectively. The optimal cut-off point
was 13 and 50 for APACHE II and PSI, respectively

Keywords

COVID-19
SARS-CoV-2
Mortality
APACHE II
Subjects
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Journal of Emergency Practice and Trauma
Volume 9, Issue 1
January 2023
Pages 19-24

  • Receive Date 30 January 2023

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