Publications

@article{Crooks2022-ng,

title = {Predicting need for escalation of care or death from repeated 

 daily clinical observations and laboratory results in patients 

 with severe acute respiratory syndrome Coronavirus 2},

author = {Colin J Crooks and Joe West and Andrew Fogarty and Joanne R Morling and Matthew J Grainge and Sherif Gonem and Mark Simmonds and Andrea Race and Irene Juurlink and Steve Briggs and Simon Cruickshank and Susan Hammond-Pears and Timothy R Card},

year  = {2022},

date = {2022-10-01},

journal = {Am. J. Epidemiol.},

volume = {191},

number = {11},

pages = {1944\textendash1953},

publisher = {Oxford University Press (OUP)},

abstract = {We compared the performance of prognostic tools for severe acute 

 respiratory syndrome coronavirus 2 (SARS-CoV-2) using parameters 

 fitted either at the time of hospital admission or across all 

 time points of an admission. This cohort study used clinical 

 data to model the dynamic change in prognosis of SARS-CoV-2 at a 

 single hospital center in the United Kingdom, including all 

 patients admitted from February 1, 2020, to December 31, 2020, 

 and then followed up for 60 days for intensive care unit (ICU) 

 admission, death, or discharge from the hospital. We 

 incorporated clinical observations and blood tests into 2 

 time-varying Cox proportional hazards models predicting daily 

 24- to 48-hour risk of admission to the ICU for those eligible 

 for escalation of care or death for those ineligible for 

 escalation. In developing the model, 491 patients were eligible 

 for ICU escalation and 769 were ineligible for escalation. Our 

 model had good discrimination of daily risk of ICU admission in the validation cohort (n = 1,141; C statistic: C = 0.91, 95% 

 confidence interval: 0.89, 0.94) and our score performed better 

 than other scores (National Early Warning Score 2, International 

 Severe Acute Respiratory and Emerging Infection Comprehensive 

 Clinical Characterisation Collaboration score) calculated using 

 only parameters measured on admission, but it overestimated the risk of escalation (calibration slope = 0.7). A bespoke daily 

 SARS-CoV-2 escalation risk prediction score can predict the need 

 for clinical escalation better than a generic early warning 

 score or a single estimation of risk calculated at admission.},

keywords = {coronavirus disease 2019, COVID-19, critical care, mortality, SARS-CoV-2, severe acute respiratory syndrome coronavirus 2, survival analysis},

pubstate = {published},

tppubtype = {article}

}