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Validation of extracorporeal membrane oxygenation mortality prediction and severity of illness scores in an international COVID-19 cohort

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Validation of extracorporeal membrane oxygenation mortality prediction and severity of illness scores in an international COVID-19 cohort. / Shah, Neel; Xue, Bing; Xu, Ziqi; Yang, Hanqing; Marwali, Eva; Dalton, Heidi; Payne, Philip P R; Lu, Chenyang; Said, Ahmed S; ISARIC Characterization Group.

In: ARTIF ORGANS, Vol. 47, No. 9, 09.2023, p. 1490-1502.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research

Harvard

Shah, N, Xue, B, Xu, Z, Yang, H, Marwali, E, Dalton, H, Payne, PPR, Lu, C, Said, AS & ISARIC Characterization Group 2023, 'Validation of extracorporeal membrane oxygenation mortality prediction and severity of illness scores in an international COVID-19 cohort', ARTIF ORGANS, vol. 47, no. 9, pp. 1490-1502. https://doi.org/10.1111/aor.14542

APA

Shah, N., Xue, B., Xu, Z., Yang, H., Marwali, E., Dalton, H., Payne, P. P. R., Lu, C., Said, A. S., & ISARIC Characterization Group (2023). Validation of extracorporeal membrane oxygenation mortality prediction and severity of illness scores in an international COVID-19 cohort. ARTIF ORGANS, 47(9), 1490-1502. https://doi.org/10.1111/aor.14542

Vancouver

Shah N, Xue B, Xu Z, Yang H, Marwali E, Dalton H et al. Validation of extracorporeal membrane oxygenation mortality prediction and severity of illness scores in an international COVID-19 cohort. ARTIF ORGANS. 2023 Sep;47(9):1490-1502. https://doi.org/10.1111/aor.14542

Bibtex

@article{6269f20bf89642b39c9dff1c9e3df1d5,
title = "Validation of extracorporeal membrane oxygenation mortality prediction and severity of illness scores in an international COVID-19 cohort",
abstract = "BACKGROUND: Veno-venous extracorporeal membrane oxygenation (V-V ECMO) is a lifesaving support modality for severe respiratory failure, but its resource-intensive nature led to significant controversy surrounding its use during the COVID-19 pandemic. We report the performance of several ECMO mortality prediction and severity of illness scores at discriminating survival in a large COVID-19 V-V ECMO cohort.METHODS: We validated ECMOnet, PRESET (PREdiction of Survival on ECMO Therapy-Score), Roch, SOFA (Sequential Organ Failure Assessment), APACHE II (acute physiology and chronic health evaluation), 4C (Coronavirus Clinical Characterisation Consortium), and CURB-65 (Confusion, Urea nitrogen, Respiratory Rate, Blood Pressure, age >65 years) scores on the ISARIC (International Severe Acute Respiratory and emerging Infection Consortium) database. We report discrimination via Area Under the Receiver Operative Curve (AUROC) and Area under the Precision Recall Curve (AURPC) and calibration via Brier score.RESULTS: We included 1147 patients and scores were calculated on patients with sufficient variables. ECMO mortality scores had AUROC (0.58-0.62), AUPRC (0.62-0.74), and Brier score (0.286-0.303). Roch score had the highest accuracy (AUROC 0.62), precision (AUPRC 0.74) yet worst calibration (Brier score of 0.3) despite being calculated on the fewest patients (144). Severity of illness scores had AUROC (0.52-0.57), AURPC (0.59-0.64), and Brier Score (0.265-0.471). APACHE II had the highest accuracy (AUROC 0.58), precision (AUPRC 0.64), and best calibration (Brier score 0.26).CONCLUSION: Within a large international multicenter COVID-19 cohort, the evaluated ECMO mortality prediction and severity of illness scores demonstrated inconsistent discrimination and calibration highlighting the need for better clinically applicable decision support tools.",
author = "Neel Shah and Bing Xue and Ziqi Xu and Hanqing Yang and Eva Marwali and Heidi Dalton and Payne, {Philip P R} and Chenyang Lu and Said, {Ahmed S} and {ISARIC Characterization Group} and Robin Kobbe",
note = "{\textcopyright} 2023 International Center for Artificial Organ and Transplantation (ICAOT) and Wiley Periodicals LLC.",
year = "2023",
month = sep,
doi = "10.1111/aor.14542",
language = "English",
volume = "47",
pages = "1490--1502",
journal = "ARTIF ORGANS",
issn = "0160-564X",
publisher = "Wiley-Blackwell",
number = "9",

}

RIS

TY - JOUR

T1 - Validation of extracorporeal membrane oxygenation mortality prediction and severity of illness scores in an international COVID-19 cohort

AU - Shah, Neel

AU - Xue, Bing

AU - Xu, Ziqi

AU - Yang, Hanqing

AU - Marwali, Eva

AU - Dalton, Heidi

AU - Payne, Philip P R

AU - Lu, Chenyang

AU - Said, Ahmed S

AU - ISARIC Characterization Group

AU - Kobbe, Robin

N1 - © 2023 International Center for Artificial Organ and Transplantation (ICAOT) and Wiley Periodicals LLC.

PY - 2023/9

Y1 - 2023/9

N2 - BACKGROUND: Veno-venous extracorporeal membrane oxygenation (V-V ECMO) is a lifesaving support modality for severe respiratory failure, but its resource-intensive nature led to significant controversy surrounding its use during the COVID-19 pandemic. We report the performance of several ECMO mortality prediction and severity of illness scores at discriminating survival in a large COVID-19 V-V ECMO cohort.METHODS: We validated ECMOnet, PRESET (PREdiction of Survival on ECMO Therapy-Score), Roch, SOFA (Sequential Organ Failure Assessment), APACHE II (acute physiology and chronic health evaluation), 4C (Coronavirus Clinical Characterisation Consortium), and CURB-65 (Confusion, Urea nitrogen, Respiratory Rate, Blood Pressure, age >65 years) scores on the ISARIC (International Severe Acute Respiratory and emerging Infection Consortium) database. We report discrimination via Area Under the Receiver Operative Curve (AUROC) and Area under the Precision Recall Curve (AURPC) and calibration via Brier score.RESULTS: We included 1147 patients and scores were calculated on patients with sufficient variables. ECMO mortality scores had AUROC (0.58-0.62), AUPRC (0.62-0.74), and Brier score (0.286-0.303). Roch score had the highest accuracy (AUROC 0.62), precision (AUPRC 0.74) yet worst calibration (Brier score of 0.3) despite being calculated on the fewest patients (144). Severity of illness scores had AUROC (0.52-0.57), AURPC (0.59-0.64), and Brier Score (0.265-0.471). APACHE II had the highest accuracy (AUROC 0.58), precision (AUPRC 0.64), and best calibration (Brier score 0.26).CONCLUSION: Within a large international multicenter COVID-19 cohort, the evaluated ECMO mortality prediction and severity of illness scores demonstrated inconsistent discrimination and calibration highlighting the need for better clinically applicable decision support tools.

AB - BACKGROUND: Veno-venous extracorporeal membrane oxygenation (V-V ECMO) is a lifesaving support modality for severe respiratory failure, but its resource-intensive nature led to significant controversy surrounding its use during the COVID-19 pandemic. We report the performance of several ECMO mortality prediction and severity of illness scores at discriminating survival in a large COVID-19 V-V ECMO cohort.METHODS: We validated ECMOnet, PRESET (PREdiction of Survival on ECMO Therapy-Score), Roch, SOFA (Sequential Organ Failure Assessment), APACHE II (acute physiology and chronic health evaluation), 4C (Coronavirus Clinical Characterisation Consortium), and CURB-65 (Confusion, Urea nitrogen, Respiratory Rate, Blood Pressure, age >65 years) scores on the ISARIC (International Severe Acute Respiratory and emerging Infection Consortium) database. We report discrimination via Area Under the Receiver Operative Curve (AUROC) and Area under the Precision Recall Curve (AURPC) and calibration via Brier score.RESULTS: We included 1147 patients and scores were calculated on patients with sufficient variables. ECMO mortality scores had AUROC (0.58-0.62), AUPRC (0.62-0.74), and Brier score (0.286-0.303). Roch score had the highest accuracy (AUROC 0.62), precision (AUPRC 0.74) yet worst calibration (Brier score of 0.3) despite being calculated on the fewest patients (144). Severity of illness scores had AUROC (0.52-0.57), AURPC (0.59-0.64), and Brier Score (0.265-0.471). APACHE II had the highest accuracy (AUROC 0.58), precision (AUPRC 0.64), and best calibration (Brier score 0.26).CONCLUSION: Within a large international multicenter COVID-19 cohort, the evaluated ECMO mortality prediction and severity of illness scores demonstrated inconsistent discrimination and calibration highlighting the need for better clinically applicable decision support tools.

U2 - 10.1111/aor.14542

DO - 10.1111/aor.14542

M3 - SCORING: Journal article

C2 - 37032544

VL - 47

SP - 1490

EP - 1502

JO - ARTIF ORGANS

JF - ARTIF ORGANS

SN - 0160-564X

IS - 9

ER -