Rapid evaluation of Coronavirus Illness Severity (RECOILS) in intensive care: Development and validation of a prognostic tool for in-hospital mortality

Drago Plečko, Nicolas Bennett, Johan Mårtensson, Tariq A Dam, Robert Entjes, Thijs C D Rettig, Dave A Dongelmans, Age D Boelens, Sander Rigter, Stefaan H A Hendriks, Remko de Jong, Marlijn J A Kamps, Marco Peters, Attila Karakus, Diederik Gommers, Dharmanand Ramnarain, Evert-Jan Wils, Sefanja Achterberg, Ralph Nowitzky, Walter van den TempelCornelis P C de Jager, Fleur G C A Nooteboom, Evelien Oostdijk, Peter Koetsier, Alexander D Cornet, Auke C Reidinga, Wouter de Ruijter, Rob J Bosman, Tim Frenzel, Louise C Urlings-Strop, Paul de Jong, Ellen G M Smit, Olaf L Cremer, D Jannet Mehagnoul-Schipper, Harald J Faber, Judith Lens, Gert B Brunnekreef, Barbara Festen-Spanjer, Tom Dormans, Daan P de Bruin, Robbert C A Lalisang, Sebastiaan J J Vonk, Martin E Haan, Lucas M Fleuren, Patrick J Thoral, Paul W G Elbers, Rinaldo Bellomo

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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 h 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.

Original languageEnglish
Pages (from-to)65-75
Number of pages11
JournalActa Anaesthesiologica Scandinavica
Volume66
Issue number1
Early online date15 Oct 2021
DOIs
Publication statusPublished - Jan 2022

Keywords

  • corona virus
  • COVID-19
  • intensive care
  • mechanical ventilation
  • respiratory failure

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