Risk Factors and Predictive Model for Mortality of Hospitalized COVID-19 Elderly Patients from a Tertiary Care Hospital in Thailand

Mallika Chuansangeam, Bunyarat Srithan, Pattharawin Pattharanitima, Pawit Phadungsaksawasdi
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Abstract

Background: Early detection of elderly patients with COVID-19 who are at high risk of mortality is vital for appropriate clinical decisions. We aimed to evaluate the risk factors associated with all-cause in-hospital mortality among elderly patients with COVID-19. Methods: In this retrospective study, the medical records of elderly patients aged over 60 who were hospitalized with COVID-19 at Thammasat University Hospital from 1 July to 30 September 2021 were reviewed. Multivariate logistic regression was used to identify independent predictors of mortality. The sum of weighted integers was used as a total risk score for each patient. Results: In total, 138 medical records of patients were reviewed. Four identified variables based on the odds ratio (age, respiratory rate, glomerular filtration rate and history of stroke) were assigned a weighted integer and were developed to predict mortality risk in hospitalized elderly patients. The AUROC of the scoring system were 0.9415 (95% confidence interval, 0.9033–0.9716). The optimized scoring system was developed and a risk score over 213 was considered a cut-off point for high mortality risk. Conclusions: A simple predictive risk score provides an initial assessment of mortality risk at the time of admission with a high degree of accuracy among hospitalized elderly patients with COVID-19.
泰国某三级医院住院COVID-19老年患者死亡率的危险因素及预测模型
背景:早期发现死亡风险高的老年COVID-19患者对于做出适当的临床决策至关重要。我们的目的是评估与老年COVID-19患者全因住院死亡率相关的危险因素。方法:回顾性分析泰国法政大学医院2021年7月1日至9月30日收治的60岁以上老年COVID-19住院患者的病历。采用多变量逻辑回归来确定死亡率的独立预测因子。加权整数之和作为每位患者的总风险评分。结果:共查阅患者病历138份。基于优势比的4个确定变量(年龄、呼吸频率、肾小球滤过率和卒中史)被赋值为加权整数,用于预测住院老年患者的死亡风险。评分系统的AUROC为0.9415(95%可信区间为0.9033-0.9716)。开发了优化的评分系统,风险评分超过213分被认为是高死亡风险的分界点。结论:简单的预测风险评分可初步评估住院老年COVID-19患者入院时的死亡风险,准确度较高。
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