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Acta Anaesthesiol Scand . Rapid evaluation of Coronavirus Illness Severity (RECOILS) in intensive care: Development and validation of a prognostic t

tetano

Editor, Senior Moderator
Acta Anaesthesiol Scand


. 2021 Oct 8.
doi: 10.1111/aas.13991. Online ahead of print.
Rapid evaluation of Coronavirus Illness Severity (RECOILS) in intensive care: Development and validation of a prognostic tool for in-hospital mortality


Drago Plečko[SUP] 1 2 [/SUP], Nicolas Bennett[SUP] 2 [/SUP], Johan Mårtensson[SUP] 3 4 [/SUP], Tariq A Dam[SUP] 1 [/SUP], Robert Entjes[SUP] 5 [/SUP], Thijs C D Rettig[SUP] 6 [/SUP], Dave A Dongelmans[SUP] 1 [/SUP], Age D Boelens[SUP] 7 [/SUP], Sander Rigter[SUP] 8 [/SUP], Stefaan H A Hendriks[SUP] 9 [/SUP], Remko de Jong[SUP] 10 [/SUP], Marlijn J A Kamps[SUP] 11 [/SUP], Marco Peters[SUP] 12 [/SUP], Attila Karakus[SUP] 13 [/SUP], Diederik Gommers[SUP] 14 [/SUP], Dharmanand Ramnarain[SUP] 15 [/SUP], Evert-Jan Wils[SUP] 16 [/SUP], Sefanja Achterberg[SUP] 17 [/SUP], Ralph Nowitzky[SUP] 18 [/SUP], Walter van den Tempel[SUP] 19 [/SUP], Cornelis P C de Jager[SUP] 20 [/SUP], Fleur G C A Nooteboom[SUP] 21 [/SUP], Evelien Oostdijk[SUP] 22 [/SUP], Peter Koetsier[SUP] 23 [/SUP], Alexander D Cornet[SUP] 24 [/SUP], Auke C Reidinga[SUP] 25 [/SUP], Wouter de Ruijter[SUP] 26 [/SUP], Rob J Bosman[SUP] 27 [/SUP], Tim Frenzel[SUP] 28 [/SUP], Louise C Urlings-Strop[SUP] 29 [/SUP], Paul de Jong[SUP] 30 [/SUP], Ellen G M Smit[SUP] 31 [/SUP], Olaf L Cremer[SUP] 32 [/SUP], D Jannet Mehagnoul-Schipper[SUP] 33 [/SUP], Harald J Faber[SUP] 34 [/SUP], Judith Lens[SUP] 35 [/SUP], Gert B Brunnekreef[SUP] 36 [/SUP], Barbara Festen-Spanjer[SUP] 37 [/SUP], Tom Dormans[SUP] 38 [/SUP], Daan P de Bruin[SUP] 39 [/SUP], Robbert C A Lalisang[SUP] 39 [/SUP], Sebastiaan J J Vonk[SUP] 39 [/SUP], Martin E Haan[SUP] 1 [/SUP], Lucas M Fleuren[SUP] 1 [/SUP], Patrick J Thoral[SUP] 1 [/SUP], Paul W G Elbers[SUP] 1 [/SUP], Rinaldo Bellomo[SUP] 40 41 42 43 [/SUP]



Affiliations

Abstract

Background: The prediction of in-hospital mortality for ICU patients with COVID-19 is fundamental to treatment and resource allocation. The main purpose was to develop an easily implemented score for such prediction.
Methods: This was an observational, multicenter, development and validation study on a national critical care dataset of COVID-19 patients. A systematic literature review was performed to determine variables possibly important for COVID-19 mortality prediction. Using a logistic multivariable model with a LASSO penalty, we developed the Rapid Evaluation of Coronavirus Illness Severity (RECOILS) score and compared its performance against published scores.
Results: Our development (validation) cohort consisted of 1480 (937) adult patients from 14 (11) Dutch ICUs admitted between March 2020 and April 2021. Median age was 65 (65) years, 31% (26%) died in hospital, 74% (72%) were males, average length of ICU stay was 7.83 (10.25) days and average length of hospital stay was 15.90 (19.92) days. Age, platelets, PaO2/FiO2 ratio, pH, blood urea nitrogen, temperature, PaCO2, Glasgow Coma Scale (GCS) score measured within +/- 24 hours of ICU admission were used to develop the score. The AUROC of RECOILS score was 0.75 (CI 0.71-0.78) which was higher than that of any previously reported predictive scores (0.68 (CI 0.64-0.71), 0.61 (CI 0.58-0.66), 0.67 (CI 0.63-0.70), 0.70 (CI 0.67-0.74) for ISARIC 4C Mortality Score, SOFA, SAPS-III, and age, respectively).
Conclusions: Using a large dataset from multiple Dutch ICUs, we developed a predictive score for mortality of COVID-19 patients admitted to ICU, which outperformed other predictive scores reported so far.

Keywords: COVID-19; corona virus; intensive care; mechanical ventilation; respiratory failure.
 
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