Association of Different Risk Scores and 30-Day Mortality in Kidney Transplant Recipients with COVID-19
<i>Background and Objectives</i>: Clinical risk scores were poorly examined in kidney transplant recipients (KTR) with COVID-19. <i>Materials and Methods</i>: This observational study compared the association and discrimination of clinical risk scores (MEWS, qCSI, VACO, PSI/P...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2023-03-01
|
| Series: | Medicina |
| Subjects: | |
| Online Access: | https://www.mdpi.com/1648-9144/59/4/657 |
| Summary: | <i>Background and Objectives</i>: Clinical risk scores were poorly examined in kidney transplant recipients (KTR) with COVID-19. <i>Materials and Methods</i>: This observational study compared the association and discrimination of clinical risk scores (MEWS, qCSI, VACO, PSI/PORT, CCI, MuLBSTA, ISTH-DIC, COVID-GRAM and 4C) with 30-day mortality in 65 hospitalized KTRs with COVID-19. Cox regression was used to derive hazard ratios (HR) and 95% confidence intervals (95% CI), and discrimination was assessed by Harrell’s C. <i>Results</i>: A significant association with 30-day mortality was demonstrated for MEWS (HR 1.65 95% CI 1.21–2.25, <i>p</i> = 0.002); qCSI (HR 1.32 95% CI 1.15–1.52, <i>p</i> < 0.001); PSI/PORT (HR 1.04 95% CI 1.02–1.07, <i>p</i> = 0.001); CCI (HR 1.79 95% CI 1.13–2.83, <i>p</i> = 0.013); MuLBSTA (HR 1.31 95% CI 1.05–1.64, <i>p</i> = 0.017); COVID-GRAM (HR 1.03 95% CI 1.01–1.06, <i>p</i> = 0.004); and 4C (HR 1.79 95% CI 1.40–2.31, <i>p</i> < 0.001). After multivariable adjustment, significant association persisted for qCSI (HR 1.33 95% CI 1.11–1.59, <i>p</i> = 0.002); PSI/PORT (HR 1.04 95% CI 1.01–1.07, <i>p</i> = 0.012); MuLBSTA (HR 1.36 95% CI 1.01–1.85, <i>p</i> = 0.046); and 4C Mortality Score (HR 1.93 95% CI 1.45–2.57, <i>p</i> < 0.001) risk scores. The best discrimination was observed with the 4C score (Harrell’s C = 0.914). <i>Conclusions</i>: Risk scores such as qCSI, PSI/PORT and 4C showed the best association with 30-day mortality amongst KTRs with COVID-19. |
|---|---|
| ISSN: | 1010-660X 1648-9144 |