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Model Prediction for In-Hospital Mortality in Patients with COVID-19: A Case-Control Study in Isfahan, Iran

机译:Covid-19患者住院死亡率模型预测:伊朗伊斯法罕的案例对照研究

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The COVID-19 pandemic has now imposed an enormous global burden as well as a large mortality in a short time period. Although there is no promising treatment, identification of early predictors of in-hospital mortality would be critically important in reducing its worldwide mortality. We aimed to suggest a prediction model for in-hospital mortality of COVID-19. In this case-control study, we recruited 513 confirmed patients with COVID-19 from February 18 to March 26, 2020 from Isfahan COVID-19 registry. Based on extracted laboratory, clinical, and demographic data, we created an in hospital mortality predictive model using gradient boosting. We also determined the diagnostic performance of the proposed model including sensitivity, specificity, and area under the curve (AUC) as well as their 95% CIs. Of 513 patients, there were 60 (11.7%) in-hospital deaths during the study period. The diagnostic values of the suggested model based on the gradient boosting method with oversampling techniques using all of the original data were specificity of 98.5% (95% CI: 96.8-99.4), sensitivity of 100% (95% CI: 94-100), negative predictive value of 100% (95% CI: 99.2-100), positive predictive value of 89.6% (95% CI: 79.7-95.7), and an AUC of 98.6%. The suggested model may be useful in making decision to patient's hospitalization where the probability of mortality may be more obvious based on the final variable. However, moderate gaps in our knowledge of the predictors of in-hospital mortality suggest further studies aiming at models for in in with COVID-19.
机译:2019冠状病毒疾病流行在全球范围内造成了巨大的负担,同时也造成了短时间内的大死亡率。尽管目前尚无有希望的治疗方法,但确定院内死亡率的早期预测因子对于降低其全球死亡率至关重要。我们的目的是2019冠状病毒疾病住院死亡率的预测模型。在2019冠状病毒疾病2019冠状病毒疾病登记病例对照研究中,我们招募了513名确诊的COVID-19患者,从2月18日到2020年3月26日,从伊斯法罕COVID-19登记处。基于提取的实验室、临床和人口统计学数据,我们使用梯度推进法创建了一个住院死亡率预测模型。我们还确定了该模型的诊断性能,包括敏感性、特异性、曲线下面积(AUC)以及它们的95%置信区间。在513例患者中,有60例(11.7%)在研究期间住院死亡。利用所有原始数据,基于梯度增强法和过采样技术的建议模型的诊断值为特异性98.5%(95%CI:96.8-99.4),敏感性100%(95%CI:94-100),阴性预测值100%(95%CI:99.2-100),阳性预测值89.6%(95%CI:79.7-95.7),AUC为98.6%。建议的模型可能有助于决定患者的住院治疗,根据最终变量,死亡率可能更明显。然而,我们对2019冠状病毒疾病的预测指标的适度差距,提示了针对COVID-19模型的进一步研究。

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