Clinical Utility of 4C Mortality Scores among Japanese COVID-19 Patients: A Multicenter Study
Background: We analyzed data from COVID-19 patients in Japan to assess the utility of the 4C mortality score as compared with conventional scorings. Methods: In this multicenter study, COVID-19 patients hospitalized between March 2020 and June 2021, over 16 years old, were recruited. The superiority...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-02-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/3/821 |
| _version_ | 1797486861568966656 |
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| author | Kazuki Ocho Hideharu Hagiya Kou Hasegawa Kouji Fujita Fumio Otsuka |
| author_facet | Kazuki Ocho Hideharu Hagiya Kou Hasegawa Kouji Fujita Fumio Otsuka |
| author_sort | Kazuki Ocho |
| collection | DOAJ |
| description | Background: We analyzed data from COVID-19 patients in Japan to assess the utility of the 4C mortality score as compared with conventional scorings. Methods: In this multicenter study, COVID-19 patients hospitalized between March 2020 and June 2021, over 16 years old, were recruited. The superiority for correctly predicting mortality and severity by applying the receiver operating characteristic (ROC) curve was compared. A Cox regression model was used to compare the length of hospitalization for each risk group of 4C mortality score. Results: Among 206 patients, 21 patients died. The area under the curve (AUC) (95% confidential interval (CI)) of the ROC curve for mortality and severity, respectively, of 4C mortality scores (0.84 (95% CI 0.76–0.92) and 0.85 (95% CI 0.80–0.91)) were higher than those of qSOFA (0.66 (95% CI 0.53–0.78) and 0.67 (95% CI 0.59–0.75)), SOFA (0.70 (95% CI 0.55–0.84) and 0.81 (95% CI 0.74–0.89)), A-DROP (0.78 (95% CI 0.69–0.88) and 0.81 (95% CI 0.74–0.88)), and CURB-65 (0.82 (95% CI 0.74–0.90) and 0.82 (95% CI 0.76–0.88)). For length of hospitalization among survivors, the intermediate- and high- or very high-risk groups had significantly lower hazard ratios, i.e., 0.48 (95% CI 0.30–0.76)) and 0.23 (95% CI 0.13–0.43) for discharge. Conclusions: The 4C mortality score is better for estimating mortality and severity in COVID-19 Japanese patients than other scoring systems. |
| first_indexed | 2024-03-09T23:40:19Z |
| format | Article |
| id | doaj.art-c8ec6f47bd7149419acc61e38475bb40 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T23:40:19Z |
| publishDate | 2022-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-c8ec6f47bd7149419acc61e38475bb402023-11-23T16:54:30ZengMDPI AGJournal of Clinical Medicine2077-03832022-02-0111382110.3390/jcm11030821Clinical Utility of 4C Mortality Scores among Japanese COVID-19 Patients: A Multicenter StudyKazuki Ocho0Hideharu Hagiya1Kou Hasegawa2Kouji Fujita3Fumio Otsuka4Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, JapanDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, JapanDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, JapanDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, JapanDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, JapanBackground: We analyzed data from COVID-19 patients in Japan to assess the utility of the 4C mortality score as compared with conventional scorings. Methods: In this multicenter study, COVID-19 patients hospitalized between March 2020 and June 2021, over 16 years old, were recruited. The superiority for correctly predicting mortality and severity by applying the receiver operating characteristic (ROC) curve was compared. A Cox regression model was used to compare the length of hospitalization for each risk group of 4C mortality score. Results: Among 206 patients, 21 patients died. The area under the curve (AUC) (95% confidential interval (CI)) of the ROC curve for mortality and severity, respectively, of 4C mortality scores (0.84 (95% CI 0.76–0.92) and 0.85 (95% CI 0.80–0.91)) were higher than those of qSOFA (0.66 (95% CI 0.53–0.78) and 0.67 (95% CI 0.59–0.75)), SOFA (0.70 (95% CI 0.55–0.84) and 0.81 (95% CI 0.74–0.89)), A-DROP (0.78 (95% CI 0.69–0.88) and 0.81 (95% CI 0.74–0.88)), and CURB-65 (0.82 (95% CI 0.74–0.90) and 0.82 (95% CI 0.76–0.88)). For length of hospitalization among survivors, the intermediate- and high- or very high-risk groups had significantly lower hazard ratios, i.e., 0.48 (95% CI 0.30–0.76)) and 0.23 (95% CI 0.13–0.43) for discharge. Conclusions: The 4C mortality score is better for estimating mortality and severity in COVID-19 Japanese patients than other scoring systems.https://www.mdpi.com/2077-0383/11/3/821COVID-19clinical score4C mortality scoremortalityseveritylength of hospitalization |
| spellingShingle | Kazuki Ocho Hideharu Hagiya Kou Hasegawa Kouji Fujita Fumio Otsuka Clinical Utility of 4C Mortality Scores among Japanese COVID-19 Patients: A Multicenter Study Journal of Clinical Medicine COVID-19 clinical score 4C mortality score mortality severity length of hospitalization |
| title | Clinical Utility of 4C Mortality Scores among Japanese COVID-19 Patients: A Multicenter Study |
| title_full | Clinical Utility of 4C Mortality Scores among Japanese COVID-19 Patients: A Multicenter Study |
| title_fullStr | Clinical Utility of 4C Mortality Scores among Japanese COVID-19 Patients: A Multicenter Study |
| title_full_unstemmed | Clinical Utility of 4C Mortality Scores among Japanese COVID-19 Patients: A Multicenter Study |
| title_short | Clinical Utility of 4C Mortality Scores among Japanese COVID-19 Patients: A Multicenter Study |
| title_sort | clinical utility of 4c mortality scores among japanese covid 19 patients a multicenter study |
| topic | COVID-19 clinical score 4C mortality score mortality severity length of hospitalization |
| url | https://www.mdpi.com/2077-0383/11/3/821 |
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