Abstract
Introduction: As the mortality rate in coronavirus disease 2019 (COVID-19) patients older than 65 years is considerable, evaluation of in-hospital mortality is crucial. This study aimed to evaluate in-hospital mortality in COVID-19 patients older than 65 years using the National Early Warning Score (NEWS), Quick Sequential Organ Failure Assessment (q-SOFA), Charlson Comorbidity Index (CCI), and Elixhauser Comorbidity Index (ECI).Methods: This retrospective study included data from 480 patients with confirmed COVID-19 and age over 65 years who were evaluated in a university emergency department in Turkey. Data from eligible but deceased COVID-19 patients was also included. NEWS, q-SOFA, CCI, and ECI scores were retrospectively calculated. All clinical data was accessed from the information management system of the hospital, retrieved, and analyzed.Results: In-hospital mortality was seen in 169 patients (169/480). Low oxygen saturation, high C-reactive protein (CRP) and urea levels, and high q-SOFA and ECI scores helped us identify mortality in high-risk patients. A statistically significant difference was found in mortality estimation between q-SOFA and ECI (p <0.001), respectively.Conclusion: Q-SOFA and ECI can be used both easily and practically in the early diagnosis of in-hospital mortality in COVID-19 positive patients over 65 years of age admitted to the emergency department. Low oxygen saturation, high CRP and urea levels, and high q-SOFA and ECI scores are helpful in identifying high-risk patients.
Highlights
As the mortality rate in coronavirus disease 2019 (COVID-19) patients older than 65 years is considerable, evaluation of in-hospital mortality is crucial
While studies have revealed that those who were admitted to the intensive care unit were older, the average age of those who died has been reported to be 64.6 years, and age >60 has been identified as a risk factor that is associated with poor prognosis and in-hospital mortality [3,4,5], with the highest mortality rate in elderly patients [6]
We aimed to compare the ability of National Early Warning Score (NEWS), Quick Sequential Organ Failure Assessment (q-SOFA), Charlson Comorbidity Index (CCI), and Elixhauser Comorbidity Index (ECI) in predicting mortality in patients aged over 65 years, who presented to the emergency department, were diagnosed with COVID-19, and required intensive care
Summary
As the mortality rate in coronavirus disease 2019 (COVID-19) patients older than 65 years is considerable, evaluation of in-hospital mortality is crucial. This study aimed to evaluate in-hospital mortality in COVID-19 patients older than 65 years using the National Early Warning Score (NEWS), Quick Sequential Organ Failure Assessment (q-SOFA), Charlson Comorbidity Index (CCI), and Elixhauser Comorbidity Index (ECI). The ECI estimates in-hospital mortality in the presence of 30 comorbid conditions [5], and it has been suggested that the National Early Warning Score (NEWS) and the Quick Sequential Organ Failure Assessment (q-SOFA) can be used to predict mortality [11,12]. We aimed to compare the ability of NEWS, q-SOFA, CCI, and ECI in predicting mortality in patients aged over 65 years, who presented to the emergency department, were diagnosed with COVID-19, and required intensive care
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