Intubated COVID-19 predictive (ICOP) score for early mortality after intubation in patients with COVID-19
Mitsuaki Nishikimi, Rehana Rasul, Cristina Sison, Daniel Jafari, Muhammad Shoaib, Koichiro Shinozaki, Timmy Li, Kei Hayashida, Daniel M. Rolston, Jamie S. Hirsch, Lance B. Becker, Matthew A. Barish, Douglas P. Barnaby, Santiago J. Miyara, Edith Burns, Stuart L. Cohen, Jennifer Cookingham, Andrew J. Dominello, Jennifer Johnson, Zachary Kozel, Brian Lima, Ariana K. McGinn, Ernesto P. Molmenti, Rachel Monane, Marc d. Paradis
Abstract
Patients with coronavirus disease 2019 (COVID-19) can have increased risk of mortality shortly after intubation. The aim of this study is to develop a model using predictors of early mortality after intubation from COVID-19. A retrospective study of 1945 intubated patients with COVID-19 admitted to 12 Northwell hospitals in the greater New York City area was performed. Logistic regression model using backward selection was applied. This study evaluated predictors of 14-day mortality after intubation for COVID-19 patients. The predictors of mortality within 14 days after intubation included older age, history of chronic kidney disease, lower mean arterial pressure or increased dose of required vasopressors, higher urea nitrogen level, higher ferritin, higher oxygen index, and abnormal pH levels. We developed and externally validated an intubated COVID-19 predictive score (ICOP). The area under the receiver operating characteristic curve was 0.75 (95% CI 0.73-0.78) in the derivation cohort and 0.71 (95% CI 0.67-0.75) in the validation cohort; both were significantly greater than corresponding values for sequential organ failure assessment (SOFA) or CURB-65 scores. The externally validated predictive score may help clinicians estimate early mortality risk after intubation and provide guidance for deciding the most effective patient therapies.