Evaluation of Modified ATRIA Risk Score in Predicting Mortality in Hospitalized Patients With COVID-19
American Journal of the Medical Sciences, cilt.362, sa.6, ss.553-561, 2021 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 362 Sayı: 6
- Basım Tarihi: 2021
- Doi Numarası: 10.1016/j.amjms.2021.06.001
- Dergi Adı: American Journal of the Medical Sciences
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, CAB Abstracts, EMBASE, MEDLINE, Veterinary Science Database
- Sayfa Sayıları: ss.553-561
- Anahtar Kelimeler: ATRIA risk score, COVID-19, Mortality, Risk stratification, SARS-CoV-2
- İstanbul Üniversitesi-Cerrahpaşa Adresli: Evet
Özet
Background: As the Modified Anticoagulation and Risk Factors in Atrial Fibrillation Risk Score (M-ATRIA-RS) encompasses prognostic risk factors of novel coronavirus-2019 (COVID-19), it may be used to predict in-hospital mortality. We aimed to investigate whether M-ATRIA-RS was an independent predictor of mortality in patients hospitalized for COVID-19 and compare its discrimination capability with CHADS, CHA2DS2-VASc, and modified CHA2DS2-VASc (mCHA2DS2-VASc)-RS. Methods: A total of 1,001 patients were retrospectively analyzed and classified into three groups based on M-ATRIA-RS, designed by changing sex criteria of ATRIA-RS from female to male: Group 1 for points 0–1 (n = 448), Group 2 for points 2–4 (n = 268), and Group 3 for points ≥5 (n = 285). Clinical outcomes were defined as in-hospital mortality, need for high-flow oxygen and/or intubation, and admission to intensive care unit. Results: As the M-ATRIA-RS increased, adverse clinical outcomes significantly increased (Group 1, 6.5%; Group 2, 15.3%; Group 3, 34.4%; p <0.001 mortality for in-hospital). Multivariate logistic regression analysis showed that M-ATRIA-RS, malignancy, troponin increase, and lactate dehydrogenase were independent predictors of in-hospital mortality (p<0.001, per scale possibility rate for ATRIA-RS 1.2). In receiver operating characteristic (ROC) analysis, the discriminative ability of M-ATRIA-RS was superior to mCHA2DS2-VASc-RS and ATRIA-RS, but similar to that Charlson Comorbidity Index (CCI) score (AUCM-ATRIA vs AUCATRIA Z-test=3.14 p = 0.002, AUCM-ATRIA vs. AUCmCHA2DS2-VASc Z-test=2.14, p = 0.03; AUCM-ATRIA vs. AUCCCI Z-test=1.46 p = 0.14). Conclusions: M-ATRIA-RS is useful to predict in-hospital mortality among patients hospitalized with COVID-19. In addition, it is superior to the mCHA2DS2-VASc-RS in predicting mortality in patients with COVID-19 and is more easily calculable than the CCI score.