TY - JOUR
T1 - Prognostic Scoring System for Mortality of Hospitalized COVID-19 Patients in Resource-Limited Settings
T2 - A Multicenter Study from COVID-19 Referral Hospitals
AU - Saldi, Siti Rizny F.
AU - Safitri, Eka Dian
AU - Setiati, Siti
AU - Ranakusuma, Respati W.
AU - Marsigit, Jessica
AU - Azwar, Muhammad K.
AU - Astuti, Puji
AU - Sari, Cut Yulia Indah
AU - Istanti, Rahmi
AU - Yulianti, Mira
AU - Rumende, Cleopas Martin
AU - Yunihastuti, Evy
AU - Susilo, Adityo
AU - Harimurti, Kuntjoro
AU - Liastuti, Lies Dina
AU - Trimartani, Trimartani
AU - Restuti, Ratna Dwi
AU - Syam, Ari Fahrial
N1 - Funding Information:
MD, Yodi, MD, Vivian Vera Adolpha, MD for collecting the data. We declare that this study was supported by grant from the Ministry of Research and Technology/National Research Innovation Board (No. 94/FI/PKS-KCOVID-19.F/VI/2020 and 398/PKS/WR III/UI/2020). Ministry of Research and Technology/National Research Innovation Board had no role in the study design, data collection, data analysis, data interpretation, writing of the report, and in the decision to submit the paper for publication.
Publisher Copyright:
© 2021, Indonesian Society of Internal Medicine. All rights reserved.
PY - 2021/10/1
Y1 - 2021/10/1
N2 - BACKGROUND: Many studies identified the risk factors and prognostic factors related to in-hospital COVID-19 mortality using sophisticated laboratory tests. Cost and the availability of supporting blood tests may be problematic in resource-limited settings. This multicenter cohort study was conducted to assess the factors associated with mortality of COVID-19 patients aged 18 years and older, based on history taking, physical examination, and simple blood tests to be used in resource-limited settings. METHODS: The study was conducted between July 2020 and January 2021 in five COVID-19 referral hospitals in Indonesia. Among 1048 confirmed cases of COVID-19, 160 (15%) died during hospitalization. RESULTS: Multivariate analysis showed eight predictors of in-hospital mortality, namely increased age, chronic kidney disease, chronic obstructive pulmonary disease, fatigue, dyspnea, altered mental status, neutrophil-lymphocyte ratio (NLR) ≥ 5.8, and severe-critical condition. This scoring system had an Area-under-the-curve (AUC) of 84.7%. With cut-off score of 6, the sensitivity was 76.3% and the specificity was 78.2%. CONCLUSION: The result of this practical prognostic scoring system may be a guide to decision making of physicians and help in the education of family members related to the possible outcome.
AB - BACKGROUND: Many studies identified the risk factors and prognostic factors related to in-hospital COVID-19 mortality using sophisticated laboratory tests. Cost and the availability of supporting blood tests may be problematic in resource-limited settings. This multicenter cohort study was conducted to assess the factors associated with mortality of COVID-19 patients aged 18 years and older, based on history taking, physical examination, and simple blood tests to be used in resource-limited settings. METHODS: The study was conducted between July 2020 and January 2021 in five COVID-19 referral hospitals in Indonesia. Among 1048 confirmed cases of COVID-19, 160 (15%) died during hospitalization. RESULTS: Multivariate analysis showed eight predictors of in-hospital mortality, namely increased age, chronic kidney disease, chronic obstructive pulmonary disease, fatigue, dyspnea, altered mental status, neutrophil-lymphocyte ratio (NLR) ≥ 5.8, and severe-critical condition. This scoring system had an Area-under-the-curve (AUC) of 84.7%. With cut-off score of 6, the sensitivity was 76.3% and the specificity was 78.2%. CONCLUSION: The result of this practical prognostic scoring system may be a guide to decision making of physicians and help in the education of family members related to the possible outcome.
KW - COVID-19
KW - mortality
KW - predictive score
KW - prognostic
KW - resource-limited settings
UR - http://www.scopus.com/inward/record.url?scp=85123568238&partnerID=8YFLogxK
M3 - Article
C2 - 35027487
AN - SCOPUS:85123568238
SN - 2338-2732
VL - 53
SP - 407
EP - 415
JO - Acta medica Indonesiana
JF - Acta medica Indonesiana
IS - 4
ER -