COVID-19 Research Paper Volume 13, Issue 3 pp 3176—3189
Development and validation of a prognostic nomogram for predicting in-hospital mortality of COVID-19: a multicenter retrospective cohort study of 4086 cases in China
- 1 Department of Respiratory Medicine, Daping Hospital, Army Medical University, Former Third Military Medical University, Chongqing, China
- 2 Wuhan Huoshenshan Hospital, Wuhan, China
- 3 College of Public Health, Southwest Medical University, Luzhou, Sichuan, China
- 4 Department of Epidemiology, College of Preventive Medicine, Army Medical University, Former Third Military Medical University, Chongqing, China
- 5 Daping Hospital, Army Medical University, Former Third Military Medical University, Chongqing, China
- 6 Wuhan Taikang Tongji Hospital, Wuhan, China
- 7 The Second Clinical College, Chongqing Medical University, Chongqing, China
- 8 Department of Endocrinology, General Hospital of Northern Theater Command, Shenyang, Liaoning, China
- 9 NCO School of Army Medical University, Former Third Military Medical University, Shijiazhuang, Hebei, China
- 10 Department of Oncology, Daping Hospital, Army Medical University, Former Third Military Medical University, Chongqing, China
Received: October 23, 2020 Accepted: December 23, 2020 Published: February 9, 2021
https://doi.org/10.18632/aging.202605How to Cite
Copyright: © 2021 Li et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract
To establish an effective nomogram for predicting in-hospital mortality of COVID-19, a retrospective cohort study was conducted in two hospitals in Wuhan, China, with a total of 4,086 hospitalized COVID-19 cases. All patients have reached therapeutic endpoint (death or discharge). First, a total of 3,022 COVID-19 cases in Wuhan Huoshenshan hospital were divided chronologically into two sets, one (1,780 cases, including 47 died) for nomogram modeling and the other (1,242 cases, including 22 died) for internal validation. We then enrolled 1,064 COVID-19 cases (29 died) in Wuhan Taikang-Tongji hospital for external validation. Independent factors included age (HR for per year increment: 1.05), severity at admission (HR for per rank increment: 2.91), dyspnea (HR: 2.18), cardiovascular disease (HR: 3.25), and levels of lactate dehydrogenase (HR: 4.53), total bilirubin (HR: 2.56), blood glucose (HR: 2.56), and urea (HR: 2.14), which were finally selected into the nomogram. The C-index for the internal resampling (0.97, 95% CI: 0.95-0.98), the internal validation (0.96, 95% CI: 0.94-0.98), and the external validation (0.92, 95% CI: 0.86-0.98) demonstrated the fair discrimination ability. The calibration plots showed optimal agreement between nomogram prediction and actual observation. We established and validated a novel prognostic nomogram that could predict in-hospital mortality of COVID-19 patients.