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<p>The objective of this study is to develop and validate a predictive model for mortality among severe COVID-19 patients who are candidates for inter-hospital transfer. A multicenter prospective observational study was conducted between 1 January 2021 and 30 April 2021 (third and fourth pandemic waves) in regional coordination centers of the Emergency Medical Services of eight Spanish autonomous communities. Hospitalized patients with severe COVID-19 transferred to other hospitals were included. Clinical variables from the initial evaluation, the triage score, and in-hospital mortality rates were collected. A Lasso-type regression analysis was performed to fit the mortality predictive model and its performance was evaluated by a leave-one-out cross-validation. Subsequently, the regional mass triage (MATER) score was created. 1,018 transferred patients were included, with a mean age of 62.3 years (SD 12), of whom 65.1% were male and 89.6% were admitted to an Intensive Care Unit. In-hospital mortality was 23.0%. The MATER score included six variables and presented good discrimination ability with an area under the curve of 0.79 (95% CI 0.77–0.81) and a good calibration with a Brier score of 0.135. The MATER score successfully predicted the mortality rate of severe COVID-19 patients and can be helpful in decision-making for triage and transfer prioritization in mass critical care surges.</p>

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A transfer triage tool for COVID-19 mass critical care surges

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年4月5日

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  • Youcef Azeli,
  • Silvia Solà-Muñoz,
  • José Trenado,
  • Javier Jacob,
  • Marta Cubedo,
  • Ricardo Delgado,
  • Edurne Miren Mugica,
  • Iraitz Fontan,
  • Antonio Bracero,
  • Cristina López-López,
  • Maria del Mar Carricondo-Avivar,
  • María José Luque-Hernández,
  • Eloy Villalba,
  • Silvia Simón,
  • María Elena Castejón,
  • Cristina Goñi,
  • César Cardenete,
  • Zita Quintela,
  • Raquel Abejón,
  • Ángel Bermejo,
  • Mario Martín,
  • Maria Ángeles Soto-García,
  • Jorge Morales-Alvarez,
  • Tatiana Cuartas-Alvarez,
  • Rafael Castro-Delgado,
  • Xavier Jiménez-Fàbrega

摘要

The objective of this study is to develop and validate a predictive model for mortality among severe COVID-19 patients who are candidates for inter-hospital transfer. A multicenter prospective observational study was conducted between 1 January 2021 and 30 April 2021 (third and fourth pandemic waves) in regional coordination centers of the Emergency Medical Services of eight Spanish autonomous communities. Hospitalized patients with severe COVID-19 transferred to other hospitals were included. Clinical variables from the initial evaluation, the triage score, and in-hospital mortality rates were collected. A Lasso-type regression analysis was performed to fit the mortality predictive model and its performance was evaluated by a leave-one-out cross-validation. Subsequently, the regional mass triage (MATER) score was created. 1,018 transferred patients were included, with a mean age of 62.3 years (SD 12), of whom 65.1% were male and 89.6% were admitted to an Intensive Care Unit. In-hospital mortality was 23.0%. The MATER score included six variables and presented good discrimination ability with an area under the curve of 0.79 (95% CI 0.77–0.81) and a good calibration with a Brier score of 0.135. The MATER score successfully predicted the mortality rate of severe COVID-19 patients and can be helpful in decision-making for triage and transfer prioritization in mass critical care surges.