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

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 (P0.05). 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