We propose a prognostic dynamic risk stratification for 48-hour in-hospital mortality in patients with COVID-19, using demographics and routinely-collected observations and laboratory tests: age, Clinical Frailty Scale score, heart rate, respiratory rate, SpO2/FiO2 ratio, white cell count, acidosis (pH < 7.35) and Interleukin-6. We train and validate the model using data from a UK teaching hospital, adopting a landmarking approach that accounts for competing risks and informative missingness. Internal validation of the model on the first wave of patients presenting between March 1 and September 12, 2020 achieves an AUROC of 0.90 (95% CI 0.87-0.93). Temporal validation on patients presenting between September 13, 2020 and January 1, 2021 gives an AUROC of 0.91 (95% CI 0.88-0.95). The resulting mortality stratification tool has the potential to provide physicians with an assessment of a patient's evolving prognosis throughout the course of active hospital treatment.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.