A robust and highly accurate mortality prediction calculator for COVID-19 patients based on Lymphocyte count, Urea, C-Reactive Protein, Age and Sex (LUCAS) with Chest X-Rays

Surajit Ray, Abhirup Banerjee, Andrew J. Swift, Joseph Fanstone, Michail Mamalakis, Bart Vorselaars, Craig Wilkie, Joby Cole, Louise S Mackenzie, Simonne Weeks

Research output: Contribution to journalArticlepeer-review

Abstract

There have been numerous risk tools written to enable triaging of SARS-CoV-2 positive patients with different levels of complexity. Here we developed a simplified risk-tool based on minimal parameters and chest x-ray (CXR) image data that predicts the survival of adult SARS-CoV-2 positive patients at hospital admission.
We analysed the NCCID database of patient blood variables and CXR images from 19 hospitals across the UK using multivariable logistic regression. The initial dataset was non-randomly split between development and internal validation dataset with 1,434 and 310 SARS-CoV-2 positive patients, respectively. External validation of the final model was conducted on 741 Accident and Emergency (A&E) admissions with suspected SARS-CoV-2 infection from a separate NHS Trust.
The LUCAS mortality score included five strongest predictors (Lymphocyte count, Urea, C-reactive protein, Age, Sex), which are available at any point of care with rapid turnaround of results. Our simple multivariable logistic model showed high discrimination for fatal outcome with the area under the Receiving Operating Characteristics curve (AUC-ROC) in development cohort 0.765 (95% confidence interval (CI): 0.738 - 0.790), in internal validation cohort 0.744 (CI: 0.673 - 0.808), and in external validation cohort 0.752 (CI: 0.713 - 0.787). The discriminatory power of LUCAS increased slightly when including the CXR image data.
LUCAS can be used to obtain valid predictions of mortality in patients within 60 days of SARS-CoV-2 RT-PCR results into low, moderate, high or very high risk of fatality.
Original languageEnglish
JournalScientific Reports
Publication statusPublished - 2022

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