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. 2022 Jan;66(1):65-75.
doi: 10.1111/aas.13991. Epub 2021 Oct 15.

Rapid Evaluation of Coronavirus Illness Severity (RECOILS) in intensive care: Development and validation of a prognostic tool for in-hospital mortality

Drago Plečko  1   2 , Nicolas Bennett  2 , Johan Mårtensson  3   4 , Tariq A Dam  1 , Robert Entjes  5 , Thijs C D Rettig  6 , Dave A Dongelmans  1 , Age D Boelens  7 , Sander Rigter  8 , Stefaan H A Hendriks  9 , Remko de Jong  10 , Marlijn J A Kamps  11 , Marco Peters  12 , Attila Karakus  13 , Diederik Gommers  14 , Dharmanand Ramnarain  15 , Evert-Jan Wils  16 , Sefanja Achterberg  17 , Ralph Nowitzky  18 , Walter van den Tempel  19 , Cornelis P C de Jager  20 , Fleur G C A Nooteboom  21 , Evelien Oostdijk  22 , Peter Koetsier  23 , Alexander D Cornet  24 , Auke C Reidinga  25 , Wouter de Ruijter  26 , Rob J Bosman  27 , Tim Frenzel  28 , Louise C Urlings-Strop  29 , Paul de Jong  30 , Ellen G M Smit  31 , Olaf L Cremer  32 , D Jannet Mehagnoul-Schipper  33 , Harald J Faber  34 , Judith Lens  35 , Gert B Brunnekreef  36 , Barbara Festen-Spanjer  37 , Tom Dormans  38 , Daan P de Bruin  39 , Robbert C A Lalisang  39 , Sebastiaan J J Vonk  39 , Martin E Haan  1 , Lucas M Fleuren  1 , Patrick J Thoral  1 , Paul W G Elbers  1 , Rinaldo Bellomo  40   41   42   43
Affiliations

Rapid Evaluation of Coronavirus Illness Severity (RECOILS) in intensive care: Development and validation of a prognostic tool for in-hospital mortality

Drago Plečko et al. Acta Anaesthesiol Scand. 2022 Jan.

Abstract

Background: The prediction of in-hospital mortality for ICU patients with COVID-19 is fundamental to treatment and resource allocation. The main purpose was to develop an easily implemented score for such prediction.

Methods: This was an observational, multicenter, development, and validation study on a national critical care dataset of COVID-19 patients. A systematic literature review was performed to determine variables possibly important for COVID-19 mortality prediction. Using a logistic multivariable model with a LASSO penalty, we developed the Rapid Evaluation of Coronavirus Illness Severity (RECOILS) score and compared its performance against published scores.

Results: Our development (validation) cohort consisted of 1480 (937) adult patients from 14 (11) Dutch ICUs admitted between March 2020 and April 2021. Median age was 65 (65) years, 31% (26%) died in hospital, 74% (72%) were males, average length of ICU stay was 7.83 (10.25) days and average length of hospital stay was 15.90 (19.92) days. Age, platelets, PaO2/FiO2 ratio, pH, blood urea nitrogen, temperature, PaCO2, Glasgow Coma Scale (GCS) score measured within +/-24 h of ICU admission were used to develop the score. The AUROC of RECOILS score was 0.75 (CI 0.71-0.78) which was higher than that of any previously reported predictive scores (0.68 [CI 0.64-0.71], 0.61 [CI 0.58-0.66], 0.67 [CI 0.63-0.70], 0.70 [CI 0.67-0.74] for ISARIC 4C Mortality Score, SOFA, SAPS-III, and age, respectively).

Conclusions: Using a large dataset from multiple Dutch ICUs, we developed a predictive score for mortality of COVID-19 patients admitted to ICU, which outperformed other predictive scores reported so far.

Keywords: COVID-19; corona virus; intensive care; mechanical ventilation; respiratory failure.

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Conflict of interest statement

The authors report no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Evaluation of RECOILS score on development and validation cohorts. ROC and PR curves of the Rapid Evaluation of Coronavirus Illness Severity (RECOILS) in the development and validation cohorts are presented, together with various possible baseline methods. The AUROC and AUPRC values are shown in brackets next to each score, respectively
FIGURE 2
FIGURE 2
Calibration of RECOILS score. Increasing values of the RECOILS score are associated with increased mortality, showing good score calibration. The average mortality rate for different values of the RECOILS score, with 95% confidence intervals are shown as bars. The red line represents the mortality risk estimated based on the formula provided in the main text
See this image and copyright information in PMC

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