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Título: | Death risk stratification in elderly patients with covid-19. A comparative cohort study in nursing homes outbreaks |
Autor: | Bernabeu Wittel, Máximo CSIC ORCID; Ternero Vega, Jara Eloísa; Díaz-Jiménez, Pablo; Conde-Guzmán, C.; Nieto-Martín, María Dolores; Moreno-Gaviño, L.; Delgado-Cuesta, Juan CSIC; Rincón Gómez, M.; Giménez-Miranda, L. CSIC ORCID; Navarro-Amuedo, María Dolores CSIC; Muñoz-García, M. M.; Calzón-Fernández, S:; Ollero Baturone, Manuel | Palabras clave: | COVID-19 Multimorbidity Death-risk PROFUND CURB-65 |
Fecha de publicación: | nov-2020 | Editor: | Elsevier BV | Citación: | Archives of Gerontology and Geriatrics 91: 104240 (2020) | Resumen: | Elderly people are more severely affected by COVID-19. Nevertheless scarce information about specific prognostic scores for this population is available. The main objective was to compare the accuracy of recently developed COVID-19 prognostic scores to that of CURB-65, Charlson and PROFUND indices in a cohort of 272 elderly patients from four nursing homes, affected by COVID-19. Accuracy was measured by calibration (calibration curves and Hosmer-Lemeshov (H-L) test), and discriminative power (area under the receiver operation curve (AUC-ROC). Negative and positive predictive values (NPV and PPV) were also obtained. Overall mortality rate was 22.4 %. Only ACP and Shi et al. out of 10 specific COVID-19 indices could be assessed. All indices but CURB-65 showed a good calibration by H-L test, whilst PROFUND, ACP and CURB-65 showed best results in calibration curves. Only CURB-65 (AUC-ROC = 0.81 [0.75–0.87])) and PROFUND (AUC-ROC = 0.67 [0.6–0.75])) showed good discrimination power. The highest NPV was obtained by CURB-65 (95 % [90–98%]), PROFUND (93 % [77–98%]), and their combination (100 % [82–100%]); whereas CURB-65 (74 % [51–88%]), and its combination with PROFUND (80 % [50–94%]) showed highest PPV. PROFUND and CURB-65 indices showed the highest accuracy in predicting death-risk of elderly patients affected by COVID-19, whereas Charlson and recent developed COVID-19 specific tools lacked it, or were not available to assess. A comprehensive clinical stratification on two-level basis (basal death risk due to chronic conditions by PROFUND index, plus current death risk due to COVID-19 by CURB-65), could be an appropriate approach. | Versión del editor: | http://dx.doi.org/10.1016/j.archger.2020.104240 | URI: | http://hdl.handle.net/10261/237446 | DOI: | 10.1016/j.archger.2020.104240 | ISSN: | 0167-4943 |
Aparece en las colecciones: | (IBIS) Artículos (PTI Salud Global) Colección Especial COVID-19 |
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