{"id":7926,"date":"2024-03-28T10:06:43","date_gmt":"2024-03-28T10:06:43","guid":{"rendered":"https:\/\/www.library.sath.nhs.uk\/research\/?p=7926"},"modified":"2024-03-28T10:08:14","modified_gmt":"2024-03-28T10:08:14","slug":"assessing-continued-benefits-of-4c-scores-for-mortality-among-patients-with-covid-19-pneumonitis-admitted-to-a-teaching-district-general-hospital-2023","status":"publish","type":"post","link":"https:\/\/www.library.sath.nhs.uk\/research\/2024\/03\/28\/assessing-continued-benefits-of-4c-scores-for-mortality-among-patients-with-covid-19-pneumonitis-admitted-to-a-teaching-district-general-hospital-2023\/","title":{"rendered":"Assessing continued benefits of 4C scores for mortality among patients with COVID-19 pneumonitis admitted to a teaching district general hospital (2023)"},"content":{"rendered":"<p><strong>Type of publication:<\/strong><br \/>\nConference abstract<\/p>\n<p><strong>Author(s):<\/strong><br \/>\nCox D.; Koshy K.; *Moudgil N.; *Makan A.; *Crawford E.; *Moudgil H.; *Srinivasan K.;<\/p>\n<p><strong>Citation:<\/strong><br \/>\nThorax. Conference: British Thoracic Society Winter Meeting 2023. London United Kingdom. 78(Supplement 4) (pp A201), 2023. Date of Publication: November 2023.<\/p>\n<p><strong>Abstract:<\/strong><br \/>\nBackground and Objectives The 4C (Coronavirus Clinical Characterisation Consortium) score incorporating patient comorbidities with measures of acute physiology and inflammation is an internationally validated prognostic tool for in-hospital mortality introduced early during the COVID-19 pandemic. With the subsequent strong uptake of SARS-CoV-2- RNA vaccines, more targeted therapies, changing virulence of the coronavirus (now predominantly omicron), and fewer reported deaths, the goal\/objectives of this work were to determine continuing relevance of 4C scores by (1) reporting their distribution categorised with risk profile and (2) further analysing mortality in the immediate in-hospital setting and at 12 months. Methods Retrospective computer-based data including SARSCoV- 2-RNA vaccination status\/boosters collected for patients with confirmed infection and COVID-19 pneumonitis admitted during 2 months to July 2022; subsequent analysis for mortality was by regression analysis accepting statistically significant findings for standardised beta coefficients at p&lt;.05 adjusting for demographics, vaccination status and targeted COVID-19 directed (Remdesivir\/Tocilizumab) therapeutic variables as well as oxygen (O<sup>2<\/sup>) and use of medical devices. Results 62 patients (47% males), with mean (SD, range) age 75.8 (15.4, 32-101) years were identified; 19 (30.6%), with mean survival 70 (67, 6-237) days (median 40 days), had died (9 in the initial admission and 10 during follow up). 55 (88.7%) had been vaccinated at least once. Distribution of 4C scores with mortality in-hospital and during follow up are shown in table 1; 8\/9 (88.9%) in-hospital and 17\/19 (89.5%) overall deaths were from patients with high or very high 4C scores. Independent variables statistically significant on regression analysis for in-hospital mortality included positively with 4C score (p= .018) and high O<sup>2<\/sup>\/medical ventilatory devices (p= .000), and negatively with age (p= .048), dexamethasone (p= .046), and targeted COVID treatments (p= .036) but not gender, status\/number of vaccines, or low dose O<sup>2<\/sup>\u00a0use. None of the variables were significant at 12 months. Conclusions Analysis of this real-life data has shown continued role for 4C scores outside of their original validation; despite no statistical significance among independent variables at 12 months, the continued mortality (30.6% in the cohort) likely reflects on the significant burden of co-morbidity.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Type of publication: Conference abstract Author(s): Cox D.; Koshy K.; *Moudgil N.; *Makan A.; *Crawford E.; *Moudgil H.; *Srinivasan K.; Citation: Thorax. Conference: British Thoracic Society Winter Meeting 2023. London United Kingdom. 78(Supplement 4) (pp A201), 2023. Date of Publication:<span class=\"ellipsis\">&hellip;<\/span><\/p>\n<div class=\"read-more\"><a href=\"https:\/\/www.library.sath.nhs.uk\/research\/2024\/03\/28\/assessing-continued-benefits-of-4c-scores-for-mortality-among-patients-with-covid-19-pneumonitis-admitted-to-a-teaching-district-general-hospital-2023\/\">Read more <span class=\"screen-reader-text\">Assessing continued benefits of 4C scores for mortality among patients with COVID-19 pneumonitis admitted to a teaching district general hospital (2023)<\/span><span class=\"meta-nav\"> &#8250;<\/span><\/a><\/div>\n<p><!-- end of .read-more --><\/p>\n","protected":false},"author":12,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"content-type":"","footnotes":""},"categories":[200],"tags":[1029,946],"class_list":["post-7926","post","type-post","status-publish","format-standard","hentry","category-staff-publication","tag-1029","tag-covid-19"],"_links":{"self":[{"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/posts\/7926","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/users\/12"}],"replies":[{"embeddable":true,"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/comments?post=7926"}],"version-history":[{"count":2,"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/posts\/7926\/revisions"}],"predecessor-version":[{"id":7929,"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/posts\/7926\/revisions\/7929"}],"wp:attachment":[{"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/media?parent=7926"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/categories?post=7926"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/tags?post=7926"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}