CURB-65, qSOFA, and SIRS Criteria in Predicting In-Hospital Mortality of Critically Ill COVID-19 Patients; a Prognostic Accuracy Study
Archives of Academic Emergency Medicine,
Vol. 10 No. 1 (2022),
1 January 2022
,
Page e36
https://doi.org/10.22037/aaem.v10i1.1565
Abstract
Introduction: Outcome prediction of intensive care unit (ICU)-admitted patients is one of the important issues for physicians. This study aimed to compare the accuracy of Quick Sequential Organ Failure Assessment (qSOFA), Confusion, Urea, Respiratory Rate, Blood Pressure and Age Above or Below 65 Years (CURB-65), and Systemic Inflammatory Response Syndrome (SIRS) scores in predicting the in-hospital mortality of COVID-19 patients.
Methods: This prognostic accuracy study was performed on 225 ICU-admitted patients with a definitive diagnosis of COVID-19 from July to December 2021 in Tehran, Iran. The patients' clinical characteristics were evaluated at the time of ICU admission, and they were followed up until discharge from ICU. The screening performance characteristics of CURB-65, qSOFA, and SIRS in predicting their mortality was compared.
Results: 225 patients with the mean age of 63.27±14.89 years were studied (56.89% male). The in-hospital mortality rate of this series of patients was 39.10%. The area under the curve (AUC) of SIRS, CURB-65, and qSOFA were 0.62 (95% CI: 0.55 - 0.69), 0.66 (95% CI: 0.59 - 0.73), and 0.61(95% CI: 0.54 - 0.67), respectively (p = 0.508). In cut-off ≥1, the estimated sensitivity values of SIRS, CURB-65, and qSOFA were 85.23%, 96.59%, and 78.41%, respectively. The estimated specificity of scores were 34.31%, 6.57%, and 38.69%, respectively. In cut-off ≥2, the sensitivity values of SIRS, CURB-65, and qSOFA were evaluated as 39.77%, 87.50%, and 15.91%, respectively. Meanwhile, the specificity of scores were 72.99%, 34.31%, and 92.70%.
Conclusions: It seems that the performance of SIRS, CURB-65, and qSOFA is similar in predicting the ICU mortality of COVID-19 patients. However, the sensitivity of CURB-65 is higher than qSOFA and SIRS.
- Systemic inflammatory response syndrome
- Organ Dysfunction Scores
- clinical decision rules
- intensive care units
- mortality
- COVID-19
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References
Almutairi MM, Yamin M, Halikias G, Sen A, Ahmed A. A Framework for Crowd Management during COVID-19 with Artificial Intelligence. Sustainability. 2022;14(1):303.
Panda S, Roy S, Garg RK, Hui G, Gorard J, Bhutada M, et al. COVID‐19 disease in hospitalized young adults in India and China: Evaluation of risk factors predicting progression across two major ethnic groups. J Med Virol. 2022;94(1):272-8.
Su Y, Ju M-j, Xie R-c, Yu S-j, Zheng J-l, Ma G-g, et al. Prognostic accuracy of early warning scores for clinical deterioration in patients with COVID-19. Front Med. 2021 ;7:624255.
Liu S, Yao N, Qiu Y, He C. Predictive performance of SOFA and qSOFA for in-hospital mortality in severe novel coronavirus disease. Am J Emerg Med. 2020;38(10):2074-80.
Bradley P, Frost F, Tharmaratnam K, Wootton DG. Utility of established prognostic scores in COVID-19 hospital admissions: multicentre prospective evaluation of CURB-65, NEWS2 and qSOFA. BMJ Open Respir. Res. 2020;7(1):e000729.
Wang L, Lv Q, Zhang X, Jiang B, Liu E, Xiao C, et al. The utility of MEWS for predicting the mortality in the elderly adults with COVID-19: a retrospective cohort study with comparison to other predictive clinical scores. PeerJ. 2020;8:e10018.
Heldt S, Neuböck M, Kainzbauer N, Shao G, Tschoellitsch T, Duenser M, et al. qSOFA score poorly predicts critical progression in COVID-19 patients. Wien Med Wochenschr. 2021:1-9.
Carriel J, Muñoz-Jaramillo R, Bolaños-Ladinez O, Heredia-Villacreses F, Menéndez-Sanchón J, Martin-Delgado J, et al. CURB-65 as a predictor of 30-day mortality in patients hospitalized with COVID-19 in Ecuador: COVID-EC study. Rev Clin Esp. 2022;222(1):37-41.
Akhter S, Warraich UA, Ghazal S, Rizvi N. Assessment and comparison of APACHE II (acute physiology and chronic health evaluation), SOFA (sequential organ failure assessment) score and curb 65 (confusion; urea; respiratory rate; blood pressure), for prediction of inpatient mortality in acute exacerbation of chronic obstructive pulmonary disease. JPMA. 2019;69(2):211-215.
Embaby KM, Attia SM, El-Saeed AS, Ismael HK. Quick Sequential Organ Failure Assessment Versus Systemic Inflammatory Response System in Early Detection of Sepsis in Emergency Department. Egypt J Hosp Med. 2021;82(4):761-7.
Lalueza A, Lora-Tamayo J, de la Calle C, Sayas-Catalán J, Arrieta E, Maestro G, et al. The early use of sepsis scores to predict respiratory failure and mortality in non-ICU patients with COVID-19. Rev Clin Esp. 2021.
Koch C, Edinger F, Fischer T, Brenck F, Hecker A, Katzer C, et al. Comparison of qSOFA score, SOFA score, and SIRS criteria for the prediction of infection and mortality among surgical intermediate and intensive care patients. World J Emerg Surg. 2020;15(1):1-10.
Jang JG, Hur J, Hong KS, Lee W, Ahn JH. Prognostic accuracy of the SIRS, qSOFA, and NEWS for early detection of clinical deterioration in SARS-CoV-2 infected patients. J Korean Med Sci. 2020; 35(25): e234.
Tyagi A, Tyagi S, Agrawal A, Mohan A, Garg D, Salhotra R, et al. Early Warning Scores at time of ICU admission to Predict Mortality in critically ill COVID-19 Patients. Disaster Med Public Health Prep. 2021:1-15.
Meawed TE, Ahmed SM, Mowafy SM, Samir GM, Anis RH. Bacterial and fungal ventilator associated pneumonia in critically ill COVID-19 patients during the second wave. J Infect Public Health. 2021;14(10):1375-80.
Fan G, Tu C, Zhou F, Liu Z, Wang Y, Song B, et al. Comparison of severity scores for COVID-19 patients with pneumonia: a retrospective study. Eur Respir J. 2020;56(3) :2002113.
Holten AR, Nore KG, Tveiten C, Olasveengen TM, Tonby K. Predicting severe COVID-19 in the Emergency Department. Resuscitation plus. 2020;4:100042.
Ilg A, Moskowitz A, Konanki V, Patel PV, Chase M, Grossestreuer AV, et al. Performance of the CURB-65 Score in Predicting Critical Care Interventions in Patients Admitted With Community-Acquired Pneumonia. Ann Emerg Med. 2019;74(1):60-8.
Shah BA, Ahmed W, Dhobi GN, Shah NN, Khursheed SQ, Haq I. Validity of pneumonia severity index and CURB-65 severity scoring systems in community acquired pneumonia in an Indian setting. Indian J Chest Dis Allied Sci. 2010;52(1):9.
Covino M, Sandroni C, Santoro M, Sabia L, Simeoni B, Bocci MG, et al. Predicting intensive care unit admission and death for COVID-19 patients in the emergency department using early warning scores. Resuscitation. 2020;156:84-91.
Saberian P, Tavakoli N, Hasani-Sharamin P, Modabber M, Jamshididana M, Baratloo A. Accuracy of the pre-hospital triage tools (qSOFA, NEWS, and PRESEP) in predicting probable COVID-19 patients’ outcomes transferred by Emergency Medical Services. Caspian J Intern Med. 2020;11(Suppl 1):536.
Liu F-Y, Sun X-L, Zhang Y, Ge L, Wang J, Liang X, et al. Evaluation of the risk prediction tools for patients with coronavirus disease 2019 in Wuhan, China: A single-centered, retrospective, observational study. Crit Care Med. 2020;48(11):e1004-e1011.
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