An easy-to-use nomogram for predicting in-hospital mortality risk in COVID-19: a retrospective cohort study in a university hospital

BMC Infect Dis. 2021 Feb 5;21(1):148. doi: 10.1186/s12879-021-05845-x.

Abstract

Background: One-fifth of COVID-19 patients are seriously and critically ill cases and have a worse prognosis than non-severe cases. Although there is no specific treatment available for COVID-19, early recognition and supportive treatment may reduce the mortality. The aim of this study is to develop a functional nomogram that can be used by clinicians to estimate the risk of in-hospital mortality in patients hospitalized and treated for COVID-19 disease, and to compare the accuracy of model predictions with previous nomograms.

Methods: This retrospective study enrolled 709 patients who were over 18 years old and received inpatient treatment for COVID-19 disease. Multivariable Logistic Regression analysis was performed to assess the possible predictors of a fatal outcome. A nomogram was developed with the possible predictors and total point were calculated.

Results: Of the 709 patients treated for COVID-19, 75 (11%) died and 634 survived. The elder age, certain comorbidities (cancer, heart failure, chronic renal failure), dyspnea, lower levels of oxygen saturation and hematocrit, higher levels of C-reactive protein, aspartate aminotransferase and ferritin were independent risk factors for mortality. The prediction ability of total points was excellent (Area Under Curve = 0.922).

Conclusions: The nomogram developed in this study can be used by clinicians as a practical and effective tool in mortality risk estimation. So that with early diagnosis and intervention mortality in COVID-19 patients may be reduced.

Keywords: COVID-19; Fatal outcome; Mortality; Nomogram; Risk factor.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • COVID-19 / mortality*
  • Female
  • Hospital Mortality*
  • Hospitals, University
  • Humans
  • Male
  • Middle Aged
  • Nomograms*
  • Predictive Value of Tests
  • Prognosis
  • ROC Curve
  • Retrospective Studies
  • Risk Assessment
  • SARS-CoV-2*
  • Sensitivity and Specificity
  • Turkey
  • Young Adult