Development and validation of the ISARIC 4C Deterioration model for adults hospitalised with COVID-19: a prospective cohort study
Loading...
Date
2021-04-24
Journal Title
Journal ISSN
Volume Title
Publisher
The Lancet Respiratory Medicine
Abstract
Prognostic models to predict the risk of clinical deterioration in acute COVID-19 cases are urgently
required to inform clinical management decisions.
We developed and validated a multivariable logistic regression model for in-hospital clinical deterioration
(defined as any requirement of ventilatory support or critical care, or death) among consecutively hospitalised adults
with highly suspected or confirmed COVID-19 who were prospectively recruited to the International Severe Acute
Respiratory and Emerging Infections Consortium Coronavirus Clinical Characterisation Consortium (ISARIC4C)
study across 260 hospitals in England, Scotland, and Wales. Candidate predictors that were specified a priori were
considered for inclusion in the model on the basis of previous prognostic scores and emerging literature describing
routinely measured biomarkers associated with COVID-19 prognosis. We used internal–external cross-validation to
evaluate discrimination, calibration, and clinical utility across eight National Health Service (NHS) regions in the
development cohort. We further validated the final model in held-out data from an additional NHS region (London).
Description
Keywords
Citation
Gupta, R. K., Harrison, E. M., Ho, A., Docherty, A. B., Knight, S. R., van Smeden, M., ... & Metelmann, S. (2021). Development and validation of the ISARIC 4C Deterioration model for adults hospitalised with COVID-19: a prospective cohort study. The Lancet Respiratory Medicine, 9(4), 349-359.