• Am. J. Med. Sci. · Dec 2021

    Evaluation of Modified ATRIA Risk Score in Predicting Mortality in Hospitalized Patients with COVID-19.

    • Gonul Aciksari, Gokhan Cetinkal, Mehmet Kocak, Yasemin Cag, Adem Atici, Lutfiye Nilsun Altunal, Hasan Ali Barman, Mehtap Aydin, Betul Balaban Kocas, Gulsum Cam, Kader Gorkem Guclu, and Mustafa Caliskan.
    • Department of Cardiology, Istanbul Medeniyet University and Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Istanbul, Turkey. Electronic address: gonul.aciksari@saglik.gov.tr.
    • Am. J. Med. Sci. 2021 Dec 1; 362 (6): 553-561.

    BackgroundAs the Modified Anticoagulation and Risk Factors in Atrial Fibrillation Risk Score (M-ATRIA-RS) encompasses prognostic risk factors of novel coronavirus-2019 (COVID-19), it may be used to predict in-hospital mortality. We aimed to investigate whether M-ATRIA-RS was an independent predictor of mortality in patients hospitalized for COVID-19 and compare its discrimination capability with CHADS, CHA2DS2-VASc, and modified CHA2DS2-VASc (mCHA2DS2-VASc)-RS.MethodsA total of 1,001 patients were retrospectively analyzed and classified into three groups based on M-ATRIA-RS, designed by changing sex criteria of ATRIA-RS from female to male: Group 1 for points 0-1 (n = 448), Group 2 for points 2-4 (n = 268), and Group 3 for points ≥5 (n = 285). Clinical outcomes were defined as in-hospital mortality, need for high-flow oxygen and/or intubation, and admission to intensive care unit.ResultsAs the M-ATRIA-RS increased, adverse clinical outcomes significantly increased (Group 1, 6.5%; Group 2, 15.3%; Group 3, 34.4%; p <0.001 mortality for in-hospital). Multivariate logistic regression analysis showed that M-ATRIA-RS, malignancy, troponin increase, and lactate dehydrogenase were independent predictors of in-hospital mortality (p<0.001, per scale possibility rate for ATRIA-RS 1.2). In receiver operating characteristic (ROC) analysis, the discriminative ability of M-ATRIA-RS was superior to mCHA2DS2-VASc-RS and ATRIA-RS, but similar to that Charlson Comorbidity Index (CCI) score (AUCM-ATRIAvs AUCATRIA Z-test=3.14 p = 0.002, AUCM-ATRIAvs. AUCmCHA2DS2-VASc Z-test=2.14, p = 0.03; AUCM-ATRIAvs. AUCCCI Z-test=1.46 p = 0.14).ConclusionsM-ATRIA-RS is useful to predict in-hospital mortality among patients hospitalized with COVID-19. In addition, it is superior to the mCHA2DS2-VASc-RS in predicting mortality in patients with COVID-19 and is more easily calculable than the CCI score.Copyright © 2021 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.

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