Abstract
To evaluate the prognostic stratification ability of 4C Mortality Score and COVID-19 Mortality Risk Score in different age groups. Retrospective study, including all patients, presented to the Emergency Department of the University Hospital Careggi, between February, 2020 and May, 2021, and admitted for SARS-CoV2. Patients were divided into four subgroups based on the quartiles of age distribution: patients < 57 years (G1, n = 546), 57–71 years (G2, n = 508), 72–81 years (G3, n = 552), and > 82 years (G4, n = 578). We calculated the 4C Mortality Score and COVID-19 Mortality Risk Score. The end-point was in-hospital mortality. In the whole population (age 68 ± 16 years), the mortality rate was 19% (n = 424), and increased with increasing age (G1: 4%, G2: 11%, G3: 22%, and G4: 39%, p < 0.001). Both scores were higher among non-survivors than survivors in all subgroups (4C-MS, G1: 6 [3–7] vs 3 [2–5]; G2: 10 [7–11] vs 7 [5–8]; G3: 11 [10–14] vs 10 [8–11]; G4: 13 [12–15] vs 11 [10–13], all p < 0.001; COVID-19 MRS, G1: 8 [7–9] vs 9 [9–11], G2: 10 [8–11] vs 11 [10–12]; G3: 11 [10–12] vs 12 [11–13]; G4: 11 [10–13] vs 13 [12–14], all p < 0.01). The ability of both scores to identify patients at higher risk of in-hospital mortality, was similar in different age groups (4C-MS: G1 0.77, G2 0.76, G3 0.68, G4 0.72; COVID-19 MRS: G1 0.67, G2 0.69, G3 0.69, G4 0.72, all p for comparisons between subgroups = NS). Both scores confirmed their good performance in predicting in-hospital mortality in all age groups, despite their different mortality rate.
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FI and LP gave substantial contributions to the conception and design of the work. GF, ADP, AL, EP, FP, MV, FT, and SM gave substantial contributions in the acquisition, and analysis of data for the work. GF, FP, and FC gave their contribution for the interpretation of data. LP and GF drafted the manuscript; FP and FI revised it critically for important intellectual content. RP gave the final approval of the version to be published.
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Pelagatti, L., Fabiani, G., De Paris, A. et al. 4C mortality score and COVID-19 mortality risk score: an analysis in four different age groups of an Italian population. Intern Emerg Med (2024). https://doi.org/10.1007/s11739-024-03551-5
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DOI: https://doi.org/10.1007/s11739-024-03551-5