Prediction of Hospital Mortality after Colorectal Perforation Surgery from Inflammation-Based Prognostic Scores

Objective: Prospectively validate two prognostic scores, pre-hospitalisation (SOARS) and hospitalised mortality prediction (4C Mortality Score), derived from the coronavirus disease 2019 (COVID-19) first wave, in the evolving second wave with prevalent B.1.1.7 and parent D614 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants, in two large United Kingdom (UK) cohorts. Design: Prospective observational cohort study of SOARS and 4C Mortality Score in PREDICT (single site) and multi-site ISARIC (International Severe Acute Respiratory and Emerging Infections Consortium) cohorts. Setting: Protocol-based data collection in UK COVID-19 second wave, between October 2020 and January 2021, from PREDICT and ISARIC cohorts. Participants: 1383 from single site PREDICT cohort and 20,595 from multi-site ISARIC cohort. Main outcome measures: Relevance of SOARS and 4C Mortality Score derived from the COVID-19 first wave, determining in-hospital mortality and safe discharge in the UK COVID-19 second wave. Results: Data from 1383 patients (median age 67y, IQR 52-82; mortality 24.7%) in the PREDICT and 20,595 patients from the ISARIC (mortality 19.4%) cohorts showed both SOARS and 4C Mortality Score remained relevant despite the B.1.1.7 variant and treatment advances. SOARS had AUC of 0.8 and 0.74, while 4C Mortality Score had an AUC of 0.83 and 0.91 for hospital mortality, in the PREDICT and ISARIC cohorts respectively, therefore effective in evaluating both safe discharge and in-hospital mortality. 19.3% (231/1195, PREDICT cohort) and 16.7% (2550/14992, ISARIC cohort) with a SOARS of 0-1 were potential candidates for home discharge to a virtual hospital (VH) model. SOARS score implementation resulted in low re-admission rates, 11.8% (27/229), and low mortality, 0.9% (2/229), in the VH pathway. Use is still suboptimal to prevent admission, as 8.1% in the PREDICT cohort and 9.5% in the ISARIC cohort were admitted despite SOARS score of 0-1. Conclusion: SOARS and 4C Mortality Score remains valid, providing accurate prognostication despite evolving viral subtype and treatment advances, which have altered mortality. Both scores are easily implemented within urgent care pathways with a scope for admission avoidance. They remain safe and relevant to their purpose, transforming complex clinical presentations into tangible numbers, aiding objective decision making. Trial registration: NHS HRA registration and REC approval (20/HRA/2344, IRAS ID 283888).

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Stroke Prognostic Scores and Data-Driven Prediction of Clinical Outcomes After Acute Ischemic Stroke

Stroke ◽

10.1161/strokeaha.119.027300 ◽

2020 ◽

Vol 51 (5) ◽

pp. 1477-1483 ◽

Cited By ~ 1

Author(s):

Koutarou Matsumoto ◽

Yasunobu Nohara ◽

Hidehisa Soejima ◽

Toshiro Yonehara ◽

Naoki Nakashima ◽

...

Keyword(s):

Ischemic Stroke ◽

Decision Tree ◽

Hospital Mortality ◽

Acute Ischemic Stroke ◽

Receiver Operating Characteristic ◽

Clinical Outcomes ◽

Functional Outcomes ◽

Operating Characteristic ◽

Data Driven ◽

Prognostic Scores

Background and Purpose— Several stroke prognostic scores have been developed to predict clinical outcomes after stroke. This study aimed to develop and validate novel data-driven predictive models for clinical outcomes by referring to previous prognostic scores in patients with acute ischemic stroke in a real-world setting. Methods— We used retrospective data of 4237 patients with acute ischemic stroke who were hospitalized in a single stroke center in Japan between January 2012 and August 2017. We first validated point-based stroke prognostic scores (preadmission comorbidities, level of consciousness, age, and neurological deficit [PLAN] score, ischemic stroke predictive risk score [IScore], and acute stroke registry and analysis of Lausanne [ASTRAL] score in all patients; Houston intraarterial recanalization therapy [HIAT] score, totaled health risks in vascular events [THRIVE] score, and stroke prognostication using age and National Institutes of Health Stroke Scale-100 [SPAN-100] in patients who received reperfusion therapy) in our cohort. We then developed predictive models using all available data by linear regression or decision tree ensembles (random forest and gradient boosting decision tree) and evaluated their area under the receiver operating characteristic curve for clinical outcomes after repeated random splits. Results— The mean (SD) age of the patients was 74.7 (12.9) years and 58.3% were men. Area under the receiver operating characteristic curves (95% CIs) of prognostic scores in our cohort were 0.92 PLAN score (0.90–0.93), 0.86 for IScore (0.85–0.87), 0.85 for ASTRAL score (0.83–0.86), 0.69 for HIAT score (0.62–0.75), 0.70 for THRIVE score (0.64–0.76), and 0.70 for SPAN-100 (0.63–0.76) for poor functional outcomes, and 0.87 for PLAN score (0.85–0.90), 0.88 for IScore (0.86–0.91), and 0.88 ASTRAL score (0.85–0.91) for in-hospital mortality. Internal validation of data-driven prediction models showed that their area under the receiver operating characteristic curves ranged between 0.88 and 0.94 for poor functional outcomes and between 0.84 and 0.88 for in-hospital mortality. Ensemble models of a decision tree tended to outperform linear regression models in predicting poor functional outcomes but not in predicting in-hospital mortality. Conclusions— Stroke prognostic scores perform well in predicting clinical outcomes after stroke. Data-driven models may be an alternative tool for predicting poststroke clinical outcomes in a real-world setting.

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Performance of four ischemic stroke prognostic scores in a Brazilian population

Arquivos de Neuro-Psiquiatria ◽

10.1590/0004-282x20160002 ◽

2016 ◽

Vol 74 (2) ◽

pp. 133-137 ◽

Cited By ~ 5

Author(s):

Gustavo W. Kuster ◽

Lívia A. Dutra ◽

Israel P. Brasil ◽

Evelyn P. Pacheco ◽

Márcio J. C. Arruda ◽

...

Keyword(s):

Ischemic Stroke ◽

Hospital Mortality ◽

Functional Outcome ◽

Area Under The Curve ◽

Brazilian Population ◽

Prognostic Scores ◽

Vascular Events ◽

Stroke Registry ◽

Primary Stroke Center ◽

Stroke Center

ABSTRACT Objective Ischemic stroke (IS) prognostic scales may help clinicians in their clinical decisions. This study aimed to assess the performance of four IS prognostic scales in a Brazilian population. Method We evaluated data of IS patients admitted at Hospital Paulistano, a Joint Commission International certified primary stroke center. In-hospital mortality and modified Rankin score at discharge were defined as the outcome measures. The performance of National Institutes of Health Stroke Scale (NIHSS), Stroke Prognostication Using Age and NIHSS (SPAN-100), Acute Stroke Registry and Analysis of Lausanne (ASTRAL), and Totaled Health Risks in Vascular Events (THRIVE) were compared. Results Two hundred six patients with a mean ± SD age of 67.58 ± 15.5 years, being 55.3% male, were included. The four scales were significantly and independently associated functional outcome. Only THRIVE was associated with in-hospital mortality. With area under the curve THRIVE and NIHSS were the scales with better performance for functional outcome and THRIVE had the best performance for mortality. Conclusion THRIVE showed the best performance among the four scales, being the only associated with in-hospital mortality.

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PERFORMANCE OF PROGNOSTIC SCORES IN AKI POPULATION IN ICU

10.36106/ijsr/4710082 ◽

2020 ◽

pp. 1-4

Author(s):

Jasmin das

Keyword(s):

Hospital Mortality ◽

Goodness Of Fit ◽

Characteristic Curve ◽

Prognostic Score ◽

Apache Ii ◽

Prognostic Scores ◽

Apache Ii Score ◽

P Value ◽

Goodness Of Fit Test ◽

Good For

Acute kidney injury in hospitalized patients is associated with high mortality rates and increased length of hospital stay. Prognostication of patients with AKI is of immense value in making decisions regarding the optimal type and intensity of treatment, patient selection, and clinical discussions on prognosis and in assessment of the quality of an ICU. Prognostic scores are comprised of relevant clinical and laboratory variables of patients associated to the clinical endpoint. There are limited studies that have evaluated which prognostic score may be used in patients with AKI. Studies have shown that APACHE II underestimates hospital mortality whereas AKI specific Liano score has better statistical correlation with mortality. Materials and methods: All patients admitted to the ICU fulfilling the inclusion criteria during the study period were recruited and evaluated for AKI by both RIFLE and AKI criteria. Prognostic scores, APACHE II and Liano were used in predicting hospital mortality. Assessment of score performance was made through analysis of the discrimination and calibration using area under a receiver operating characteristic curve (AUROC) and Hosmer and Lemeshow goodness of fit test. Results: Mean APACHE II score was higher in AKI subjects compared to non AKI and was statistically significant and it increased with the severity of AKI. The AUROC for APACHE II score was 0.739 and 0.706 for AKIN and RIFLE respectively and signifies APACHE II score increases with AKI. An AUROC curve of prognostic scores for predicting mortality was 0.677 and 0.639 for Liano and APACHE II respectively and on comparison showed insignificant p value (0.6331). Assessment of calibration showed that the calibration was good for specific score. Conclusion:Assessment of performance of both the prognostic scores APACHE II and Liano had poor discrimination but calibration was good for Liano model

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Prognostic Value of Preoperative Inflammation-Based Prognostic Scores on Hospital Mortality after Gastric Cancer Surgery

Asian Pacific Journal of Cancer Prevention ◽

10.7314/apjcp.2014.15.18.7909 ◽

2014 ◽

Vol 15 (18) ◽

pp. 7909-7911

Author(s):

Tolga Dinc ◽

Baris Dogu Yildiz ◽

Ilgaz Kayilioglu ◽

Isa Sozen ◽

Mesut Tez ◽

...

Keyword(s):

Gastric Cancer ◽

Hospital Mortality ◽

Prognostic Value ◽

Cancer Surgery ◽

Prognostic Scores ◽

Gastric Cancer Surgery

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Evaluation of PORT/PSI and SOFA scores in predicting in-hospital mortality of patients with COVID-19

Microbes, Infection and Chemotherapy ◽

10.54034/mic.e1196 ◽

2021 ◽

Vol 1 ◽

pp. e1196

Author(s):

José M. Alanís-Naranjo ◽

Salvador Hernández-Sandoval ◽

Víctor M. Anguiano-Álvarez ◽

Eduardo F. Hammeken-Larrondo ◽

Gabriela Olguín-Contreras ◽

...

Keyword(s):

Hospital Mortality ◽

Sofa Score ◽

Area Under The Curve ◽

Roc Curves ◽

Prognostic Scores ◽

Limited Information ◽

Good Tool ◽

Predictive Values ◽

Study Population ◽

Sensitivity Specificity

Introduction: There is limited information analyzing the utility of different prognostic scores in predicting in-hospital mortality among patients with COVID-19. This study aimed to evaluate the performance of PORT/PSI and SOFA scores in predicting the in-hospital mortality of patients with COVID-19. Material and methods: This was an observational, analytical, and retrospective study that included consecutive patients hospitalized for COVID-19 from April 1, 2020, to May 31, 2020. The study population was characterized, and ROC analysis was performed and used to calculate the area under the curve of PORT/PSI and SOFA scores as well as the sensitivity, specificity, and predictive values. Results: A total of 151 patients were included, with a median age of 52 years (IQR 45-64); 69.5% were men, with a median BMI of 29.3 kg/m2 (IQR 25.5-34.7). Of the total, 102 patients died during hospitalization (67.5%). The areas under the ROC curves for predicting in-hospital mortality were 0.74 (95% CI 0.67-0.81) for the SOFA score and 0.85 (95% CI 0.78-0.90) for the PORT/PSI score. When compared, the PORT/PSI score predicted mortality significantly better than the SOFA score (p: 0.01). Conclusions: The PORT/PSI score is a good tool to predict in-hospital mortality in patients with COVID-19.

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Comparison Of Clif-Sofa with other Prognostic Scores in Determining the In-Hospital Mortality in Patients with Acute on Chronic Liver Failure

Journal of Clinical and Experimental Hepatology ◽

10.1016/j.jceh.2014.02.015 ◽

2014 ◽

Vol 4 ◽

pp. S3-S4

Author(s):

Ajay Duseja ◽

Swastik Agrawal ◽

Tarana Gupta ◽

Radha Krishan Dhiman ◽

Yogesh Chawla

Keyword(s):

Hospital Mortality ◽

Liver Failure ◽

Chronic Liver ◽

Prognostic Scores ◽

Chronic Liver Failure

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Risk scoring systems to predict in-hospital mortality in patients with acute variceal bleeding due to HCV-induced liver cirrhosis

Gastroenterology Insights ◽

10.4081/gi.2018.7629 ◽

2018 ◽

Vol 9 (1) ◽

Author(s):

Moataz Hassanien ◽

Maged El-Ghannam ◽

Mohamed Darwish El-Talkawy ◽

Yosry Abdelrahman ◽

Gamal El Attar ◽

...

Keyword(s):

Liver Cirrhosis ◽

Hospital Mortality ◽

Clinical Outcomes ◽

Variceal Bleeding ◽

Scoring Systems ◽

Prognostic Scores ◽

Acute Variceal Bleeding ◽

Significant Difference ◽

History Of ◽

Risk Scoring

Background: this study was designed to validate and to compare accuracy of the prognostic scores; mainly Child Turcotte Pugh (CTP), creatinine-modified Child Turcotte Pugh (CTP-Cr), MELD, albumin bilirubin score (ALBI), and AIMS65, for the predicting clinical outcomes in cirrhotic Egyptian patients presenting with acute variceal bleeding (AVB). Methods: Retrospective single center study involving 725 patients presenting with AVB due to liver cirrhosis and HCV infection either alone or mixed with HBV infection. In hospital mortality prognostic scores were calculated; mainly CTP, modified CTP-Cr, MELD, ALBI, AIMS65. The endpoint is either patient improvement or death. Results: 725 patients were included over 1-year period. 547 (75%) survived and 178 (25%) died. Patients presented with hematemesis (515/71%), melena (120/16.5%) or hematemesis and melena (90/12.5%). Those with hematemesis for the first time were 241 (33%) and recurrent attacks were 484 (66.8%). The non-survivors had significantly more incidence of shock on presentation, more blood transfused units, history of NSAIDS intake, more ICU admission days and were more likely to be Childs C. Child, modified CTP-Cr, MELD, ALBI and ALMS65 scoring systems showed significant difference between survivors and non-survivors. Conclusion: Liver specific scores (Child, MELD) and gastrointestinal bleeding scoring systems (ALBI, AIMS65) are useful in predicting clinical outcomes of AVB in cirrhotic patients. CTP-Cr score had the highest prognostic capability of in hospital mortality. Presence of active bleeding at time of endoscopy, more complications, old age, shock and higher CPT-Cr score are additional independent predictors of in hospital mortality.

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The changing in-hospital mortality of alcoholic hepatitis

Gastroenterology ◽

10.1016/s0016-5085(01)82701-3 ◽

2001 ◽

Vol 120 (5) ◽

pp. A544-A544

Author(s):

Y GUNDAMRAG ◽

A QUADRI ◽

N VAKIL

Keyword(s):

Hospital Mortality ◽

Alcoholic Hepatitis

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