• Emergencias · Aug 2021

    Observational Study

    Mortality in patients treated for COVID-19 in the emergency department of a tertiary care hospital during the first phase of the pandemic: Derivation of a risk model for emergency departments.

    • Ana García-Martínez, Beatriz López-Barbeito, Blanca Coll-Vinent, Arrate Placer, Carme Font, Rosa VargasCarmenCÁrea de Urgencias, Hospital Clinic, Barcelona, España. Universitat de Barcelona, España., Carolina Sánchez, Daniela Piñango, Elisenda Gómez-Angelats, David Curtelin, Emilio Salgado, Francisco Aya, Gemma Martínez-Nadal, José Ramón Alonso, Julia García-Gozalbes, Leticia Fresco, Miguel Galicia, Milagrosa Perea, Miriam Carbó, Nerea Iniesta, Ona Escoda, Rafael Perelló, Sandra Cuerpo, Vanesa Flores, Xavier Alemany, Òscar Miró, Mª Del Mar Ortega Romero, and Grupo de Trabajo sobre la atención de la COVID-19 en Urgencias (COVID19-URG).
    • Área de Urgencias, Hospital Clinic, Barcelona, España. Universitat de Barcelona, España.
    • Emergencias. 2021 Aug 1; 33 (4): 273-281.

    ObjectivesTo develop a risk model to predict 30-day mortality after emergency department treatment for COVID-19.Material And MethodsObservational retrospective cohort study including 2511 patients with COVID-19 who came to our emergency department between March 1 and April 30, 2020. We analyzed variables with Kaplan Meier survival and Cox regression analyses.ResultsAll-cause mortality was 8% at 30 days. Independent variables associated with higher risk of mortality were age over 50 years, a Barthel index score less than 90, altered mental status, the ratio of arterial oxygen saturation to the fraction of inspired oxygen (SaO2/FIO2), abnormal lung sounds, platelet concentration less than 100 000/mm3, a C-reactive protein concentration of 5 mg/dL or higher, and a glomerular filtration rate less than 45 mL/min. Each independent predictor was assigned 1 point in the score except age, which was assigned 2 points. Risk was distributed in 3 levels: low risk (score of 4 points or less), intermediate risk (5 to 6 points), and high risk (7 points or above). Thirty-day risk of mortality was 1.7% for patients who scored in the low-risk category, 28.2% for patients with an intermediate risk score, and 67.3% for those with a high risk score.ConclusionThis mortality risk stratification tool for patients with COVID-19 could be useful for managing the course of disease and assigning health care resources in the emergency department.

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