External Validation and Recalibration of the CURB-65 and PSI for Predicting 30-Day Mortality and Critical Care Intervention in Multiethnic Patients with COVID-19
Objectives: To validate and recalibrate the CURB-65 and pneumonia severity index (PSI) in predicting 30-day mortality and critical care intervention (CCI) in a multiethnic population with COVID-19, along with evaluating both models in predicting CCI.Methods: Retrospective data was collected for 1181...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2021-10-01
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| Series: | International Journal of Infectious Diseases |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1201971221006603 |
| _version_ | 1818394409056600064 |
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| author | Amr Elmoheen Ibrahim Abdelhafez Waleed Salem Mohamed Bahgat Ali Elkandow Amina Tarig Nauman Arshad Khoulod Mohamed Maryam Al-Hitmi Mona Saad Fatima Emam Samah Taha Khalid Bashir Aftab Azad |
| author_facet | Amr Elmoheen Ibrahim Abdelhafez Waleed Salem Mohamed Bahgat Ali Elkandow Amina Tarig Nauman Arshad Khoulod Mohamed Maryam Al-Hitmi Mona Saad Fatima Emam Samah Taha Khalid Bashir Aftab Azad |
| author_sort | Amr Elmoheen |
| collection | DOAJ |
| description | Objectives: To validate and recalibrate the CURB-65 and pneumonia severity index (PSI) in predicting 30-day mortality and critical care intervention (CCI) in a multiethnic population with COVID-19, along with evaluating both models in predicting CCI.Methods: Retrospective data was collected for 1181 patients admitted to the largest hospital in Qatar with COVID-19 pneumonia. The area under the curve (AUC), calibration curves, and other metrics were bootstrapped to examine the performance of the models. Variables constituting the CURB-65 and PSI scores underwent further analysis using the Least Absolute Shrinkage and Selection Operator (LASSO) along with logistic regression to develop a model predicting CCI. Complex machine learning models were built for comparative analysis.Results: The PSI performed better than CURB-65 in predicting 30-day mortality (AUC 0.83, 0.78 respectively), while CURB-65 outperformed PSI in predicting CCI (AUC 0.78, 0.70 respectively). The modified PSI/CURB-65 model (respiratory rate, oxygen saturation, hematocrit, age, sodium, and glucose) predicting CCI had excellent accuracy (AUC 0.823) and good calibration.Conclusions: Our study recalibrated, externally validated the PSI and CURB-65 for predicting 30-day mortality and CCI, and developed a model for predicting CCI. Our tool can potentially guide clinicians in Qatar to stratify patients with COVID-19 pneumonia. |
| first_indexed | 2024-12-14T06:00:44Z |
| format | Article |
| id | doaj.art-efa30a1a3f5c4337bb321f0c9bb152bd |
| institution | Directory Open Access Journal |
| issn | 1201-9712 |
| language | English |
| last_indexed | 2024-12-14T06:00:44Z |
| publishDate | 2021-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Infectious Diseases |
| spelling | doaj.art-efa30a1a3f5c4337bb321f0c9bb152bd2022-12-21T23:14:26ZengElsevierInternational Journal of Infectious Diseases1201-97122021-10-01111108116External Validation and Recalibration of the CURB-65 and PSI for Predicting 30-Day Mortality and Critical Care Intervention in Multiethnic Patients with COVID-19Amr Elmoheen0Ibrahim Abdelhafez1Waleed Salem2Mohamed Bahgat3Ali Elkandow4Amina Tarig5Nauman Arshad6Khoulod Mohamed7Maryam Al-Hitmi8Mona Saad9Fatima Emam10Samah Taha11Khalid Bashir12Aftab Azad13Department of Emergency Medicine, Hamad Medical Corporation, Doha, Qatar; College of Medicine, QU Health, Qatar University, Doha, Qatar; Correspondence author. Amr Elmoheen, Consultant Emergency Medicine, Department of Emergency Medicine, Hamad Medical Corporation, P.O. Box 3050, Doha, Qatar, +97433695722College of Medicine, QU Health, Qatar University, Doha, QatarDepartment of Emergency Medicine, Hamad Medical Corporation, Doha, Qatar; College of Medicine, QU Health, Qatar University, Doha, QatarDepartment of Emergency Medicine, Hamad Medical Corporation, Doha, QatarDepartment of Emergency Medicine, Hamad Medical Corporation, Doha, QatarDepartment of Emergency Medicine, Hamad Medical Corporation, Doha, QatarDepartment of Emergency Medicine, Hamad Medical Corporation, Doha, QatarCollege of Medicine, QU Health, Qatar University, Doha, QatarCollege of Medicine, QU Health, Qatar University, Doha, QatarCollege of Medicine, QU Health, Qatar University, Doha, QatarCollege of Medicine, QU Health, Qatar University, Doha, QatarCollege of Medicine, QU Health, Qatar University, Doha, QatarDepartment of Emergency Medicine, Hamad Medical Corporation, Doha, Qatar; College of Medicine, QU Health, Qatar University, Doha, QatarDepartment of Emergency Medicine, Hamad Medical Corporation, Doha, Qatar; College of Medicine, QU Health, Qatar University, Doha, QatarObjectives: To validate and recalibrate the CURB-65 and pneumonia severity index (PSI) in predicting 30-day mortality and critical care intervention (CCI) in a multiethnic population with COVID-19, along with evaluating both models in predicting CCI.Methods: Retrospective data was collected for 1181 patients admitted to the largest hospital in Qatar with COVID-19 pneumonia. The area under the curve (AUC), calibration curves, and other metrics were bootstrapped to examine the performance of the models. Variables constituting the CURB-65 and PSI scores underwent further analysis using the Least Absolute Shrinkage and Selection Operator (LASSO) along with logistic regression to develop a model predicting CCI. Complex machine learning models were built for comparative analysis.Results: The PSI performed better than CURB-65 in predicting 30-day mortality (AUC 0.83, 0.78 respectively), while CURB-65 outperformed PSI in predicting CCI (AUC 0.78, 0.70 respectively). The modified PSI/CURB-65 model (respiratory rate, oxygen saturation, hematocrit, age, sodium, and glucose) predicting CCI had excellent accuracy (AUC 0.823) and good calibration.Conclusions: Our study recalibrated, externally validated the PSI and CURB-65 for predicting 30-day mortality and CCI, and developed a model for predicting CCI. Our tool can potentially guide clinicians in Qatar to stratify patients with COVID-19 pneumonia.http://www.sciencedirect.com/science/article/pii/S1201971221006603COVID-19CURB-65PSImortalitycritical care intervention |
| spellingShingle | Amr Elmoheen Ibrahim Abdelhafez Waleed Salem Mohamed Bahgat Ali Elkandow Amina Tarig Nauman Arshad Khoulod Mohamed Maryam Al-Hitmi Mona Saad Fatima Emam Samah Taha Khalid Bashir Aftab Azad External Validation and Recalibration of the CURB-65 and PSI for Predicting 30-Day Mortality and Critical Care Intervention in Multiethnic Patients with COVID-19 International Journal of Infectious Diseases COVID-19 CURB-65 PSI mortality critical care intervention |
| title | External Validation and Recalibration of the CURB-65 and PSI for Predicting 30-Day Mortality and Critical Care Intervention in Multiethnic Patients with COVID-19 |
| title_full | External Validation and Recalibration of the CURB-65 and PSI for Predicting 30-Day Mortality and Critical Care Intervention in Multiethnic Patients with COVID-19 |
| title_fullStr | External Validation and Recalibration of the CURB-65 and PSI for Predicting 30-Day Mortality and Critical Care Intervention in Multiethnic Patients with COVID-19 |
| title_full_unstemmed | External Validation and Recalibration of the CURB-65 and PSI for Predicting 30-Day Mortality and Critical Care Intervention in Multiethnic Patients with COVID-19 |
| title_short | External Validation and Recalibration of the CURB-65 and PSI for Predicting 30-Day Mortality and Critical Care Intervention in Multiethnic Patients with COVID-19 |
| title_sort | external validation and recalibration of the curb 65 and psi for predicting 30 day mortality and critical care intervention in multiethnic patients with covid 19 |
| topic | COVID-19 CURB-65 PSI mortality critical care intervention |
| url | http://www.sciencedirect.com/science/article/pii/S1201971221006603 |
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