Id |
Subject |
Object |
Predicate |
Lexical cue |
T3 |
0-9 |
Sentence |
denotes |
Objective |
T4 |
10-152 |
Sentence |
denotes |
To develop and validate a pragmatic risk score to predict mortality in patients admitted to hospital with coronavirus disease 2019 (covid-19). |
T5 |
154-160 |
Sentence |
denotes |
Design |
T6 |
161-200 |
Sentence |
denotes |
Prospective observational cohort study. |
T7 |
202-209 |
Sentence |
denotes |
Setting |
T8 |
210-516 |
Sentence |
denotes |
International Severe Acute Respiratory and emerging Infections Consortium (ISARIC) World Health Organization (WHO) Clinical Characterisation Protocol UK (CCP-UK) study (performed by the ISARIC Coronavirus Clinical Characterisation Consortium—ISARIC-4C) in 260 hospitals across England, Scotland, and Wales. |
T9 |
517-739 |
Sentence |
denotes |
Model training was performed on a cohort of patients recruited between 6 February and 20 May 2020, with validation conducted on a second cohort of patients recruited after model development between 21 May and 29 June 2020. |
T10 |
741-753 |
Sentence |
denotes |
Participants |
T11 |
754-861 |
Sentence |
denotes |
Adults (age ≥18 years) admitted to hospital with covid-19 at least four weeks before final data extraction. |
T12 |
863-883 |
Sentence |
denotes |
Main Outcome Measure |
T13 |
884-906 |
Sentence |
denotes |
In-hospital mortality. |
T14 |
908-915 |
Sentence |
denotes |
Results |
T15 |
916-1055 |
Sentence |
denotes |
35 463 patients were included in the derivation dataset (mortality rate 32.2%) and 22 361 in the validation dataset (mortality rate 30.1%). |
T16 |
1056-1328 |
Sentence |
denotes |
The final 4C Mortality Score included eight variables readily available at initial hospital assessment: age, sex, number of comorbidities, respiratory rate, peripheral oxygen saturation, level of consciousness, urea level, and C reactive protein (score range 0-21 points). |
T17 |
1329-1520 |
Sentence |
denotes |
The 4C Score showed high discrimination for mortality (derivation cohort: area under the receiver operating characteristic curve 0.79, 95% confidence interval 0.78 to 0.79; validation cohort: |
T18 |
1521-1620 |
Sentence |
denotes |
0.77, 0.76 to 0.77) with excellent calibration (validation: calibration-in-the-large=0, slope=1.0). |
T19 |
1621-1831 |
Sentence |
denotes |
Patients with a score of at least 15 (n=4158, 19%) had a 62% mortality (positive predictive value 62%) compared with 1% mortality for those with a score of 3 or less (n=1650, 7%; negative predictive value 99%). |
T20 |
1832-2082 |
Sentence |
denotes |
Discriminatory performance was higher than 15 pre-existing risk stratification scores (area under the receiver operating characteristic curve range 0.61-0.76), with scores developed in other covid-19 cohorts often performing poorly (range 0.63-0.73). |
T21 |
2084-2095 |
Sentence |
denotes |
Conclusions |
T22 |
2096-2234 |
Sentence |
denotes |
An easy-to-use risk stratification score has been developed and validated based on commonly available parameters at hospital presentation. |
T23 |
2235-2453 |
Sentence |
denotes |
The 4C Mortality Score outperformed existing scores, showed utility to directly inform clinical decision making, and can be used to stratify patients admitted to hospital with covid-19 into different management groups. |
T24 |
2454-2544 |
Sentence |
denotes |
The score should be further validated to determine its applicability in other populations. |
T25 |
2546-2564 |
Sentence |
denotes |
Study Registration |
T26 |
2565-2579 |
Sentence |
denotes |
ISRCTN66726260 |