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Prognostic usefulness of severity scales for the initial assessment of elderly people with a diagnosis of pneumonia due to COVID-19. Design of a multivariate predictive model of mortality

Carolina Andrea Urbina Carrera, Raúl López-Izquierdo, Tomás Ruiz Albi, Jesús Francisco Bermejo-Martín, Raquel Almansa, Fátima Villafañe Sanz, Lucia Arroyo Olmedo, Susana Sánchez Ramón, Francisco Martín-Rodríguez, Fernando Moreno Torrero, Daniel Álvarez, Félix Del Campo Matía
European Respiratory Journal 2021 58: PA3665; DOI: 10.1183/13993003.congress-2021.PA3665
Carolina Andrea Urbina Carrera
1Pneumology Department - Hospital Universitario Rio Hortega, Valladolid, Spain
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  • For correspondence: carourbina90@gmail.com
Raúl López-Izquierdo
2Emergency Department - Hospital Universitario Rio Hortega, Faculty of Medicine- University of Valladolid, Valladolid, Spain
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Tomás Ruiz Albi
1Pneumology Department - Hospital Universitario Rio Hortega, Valladolid, Spain
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Jesús Francisco Bermejo-Martín
3Grupo de Investigación Biomédica en Infección Respiratoria y Sepsis (Biosepsis) (IBSAL), Centro de Investigación Biomédica en Red en Enfermedades Respiratorias (CIBERES). Instituto de Salud Carlos, Madrid, Spain
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Raquel Almansa
3Grupo de Investigación Biomédica en Infección Respiratoria y Sepsis (Biosepsis) (IBSAL), Centro de Investigación Biomédica en Red en Enfermedades Respiratorias (CIBERES). Instituto de Salud Carlos, Madrid, Spain
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Fátima Villafañe Sanz
4Emergency Department - Hospital Universitario Rio Hortega, Valladolid, Spain
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Lucia Arroyo Olmedo
1Pneumology Department - Hospital Universitario Rio Hortega, Valladolid, Spain
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Susana Sánchez Ramón
2Emergency Department - Hospital Universitario Rio Hortega, Faculty of Medicine- University of Valladolid, Valladolid, Spain
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Francisco Martín-Rodríguez
5Mobile Emergency Unit- Gerencia de Emergencias Sanitarias de Castilla y León (SACYL), Faculty of Medicine- University of Valladolid, Valladolid, Spain
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Fernando Moreno Torrero
1Pneumology Department - Hospital Universitario Rio Hortega, Valladolid, Spain
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Daniel Álvarez
6Pneumology Department - Hospital Universitario Rio Hortega, Centro de Investigación Biomédica en Red en Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN). Instituto de Salud Carlos III, Grupo de Ingeniería Biomédica (GIB)- University of Valladolid, Valladolid, Spain
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Félix Del Campo Matía
7Pneumology Department - Hospital Universitario Rio Hortega, Centro de Investigación Biomédica en Red en Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN). Instituto de Salud Carlos III, Faculty of Medicine - University of Valladolid, Valladolid, Spain
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Abstract

Introduction: The elderly are the population group most vulnerable to COVID-19. To identify risk factors associated with poor evolution is important. The aim of this study is to analyze the prognostic value of three severity scales (Pneumonia Severity Index: PSI; CURB-65 scale; Severity Community Acquired Pneumonia Score: SCAP) and to design a novel predictive model for intra-hospital mortality in patients ageing ≥75 admitted due to pneumonia linked to COVID-19.

Methods: Retrospective study. Demographic, clinical and blood test variables were obtained. The PSI, CURB-65, and SCAP severity scales were assessed as predictors of mortality. A multivariate predictive model was composed using stepwise logistic regression.

Results: A total of 186 patients were involved. Mortality reached 47.3%. PSI, CURB-65 and SCAP severity scales achieved moderate performance, with area under the curve (AUC) equal to 0.74 (95%CI 0.64-0.82), 0.71 (95%CI 0.62-0.79) and 0.72 (95%CI 0.63-0.81), respectively. The predictive model composed of the absence or presence of symptoms (cough, dyspnea), comorbidity (Charlson index) and analytics (levels of aspartate-aminotransferase, potassium, urea, dehydrogenase-lactate) achieved an AUC of 0.81 (95%CI 0.73-0.88). The decision curves showed that the predictive model had higher net benefit than the severity scales for all probability theresholds.

Conclusion: PSI, CURB65, SCAP scales can help professionals to asses the prognosis of elderly patients diagnosed with COVID-19 pneumonia. However, the novel predictive model of mortality significantly improves the performance of those scales.

  • Covid-19
  • Elderly

Footnotes

Cite this article as: European Respiratory Journal 2021; 58: Suppl. 65, PA3665.

This abstract was presented at the 2021 ERS International Congress, in session “Prediction of exacerbations in patients with COPD”.

This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).

  • Copyright ©the authors 2021
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Prognostic usefulness of severity scales for the initial assessment of elderly people with a diagnosis of pneumonia due to COVID-19. Design of a multivariate predictive model of mortality
Carolina Andrea Urbina Carrera, Raúl López-Izquierdo, Tomás Ruiz Albi, Jesús Francisco Bermejo-Martín, Raquel Almansa, Fátima Villafañe Sanz, Lucia Arroyo Olmedo, Susana Sánchez Ramón, Francisco Martín-Rodríguez, Fernando Moreno Torrero, Daniel Álvarez, Félix Del Campo Matía
European Respiratory Journal Sep 2021, 58 (suppl 65) PA3665; DOI: 10.1183/13993003.congress-2021.PA3665

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Prognostic usefulness of severity scales for the initial assessment of elderly people with a diagnosis of pneumonia due to COVID-19. Design of a multivariate predictive model of mortality
Carolina Andrea Urbina Carrera, Raúl López-Izquierdo, Tomás Ruiz Albi, Jesús Francisco Bermejo-Martín, Raquel Almansa, Fátima Villafañe Sanz, Lucia Arroyo Olmedo, Susana Sánchez Ramón, Francisco Martín-Rodríguez, Fernando Moreno Torrero, Daniel Álvarez, Félix Del Campo Matía
European Respiratory Journal Sep 2021, 58 (suppl 65) PA3665; DOI: 10.1183/13993003.congress-2021.PA3665
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