cliot (version 1.0.0)

isaric_4c_mortality: 4C Mortality Score for COVID-19

Description

Calculates the ISARIC 4C Mortality Score to predict in-hospital mortality risk for patients admitted with COVID-19. This score was derived from a large UK cohort and outperforms many other risk stratification tools. It assigns patients to Low, Intermediate, High, or Very High risk groups.

Usage

isaric_4c_mortality(age, sex, comorbidities, resp_rate, o2_sat, gcs,
                    urea, crp, urea_units = "mmol/L", crp_units = "mg/L")

Value

A list containing:

Total_Score

The calculated 4C Mortality Score (Range 0-21).

Risk_Group

Risk classification (Low, Intermediate, High, Very High).

Est_In_Hospital_Mortality

Estimated mortality percentage based on the validation cohort.

Recommendation

Clinical management suggestion.

Arguments

age

Numeric. Patient age in years.

sex

String. Biological sex ("Male" or "Female").

comorbidities

Numeric. Number of relevant comorbidities (0, 1, or >=2). Relevant comorbidities include: Chronic cardiac disease, chronic respiratory disease (excluding asthma), chronic renal disease (eGFR <= 30), mild-severe liver disease, dementia, chronic neurological conditions, connective tissue disease, diabetes.

resp_rate

Numeric. Respiratory rate in breaths per minute.

o2_sat

Numeric. Peripheral oxygen saturation (%) on room air.

gcs

Numeric. Glasgow Coma Scale score (3-15).

urea

Numeric. Serum Urea or BUN level.

crp

Numeric. C-Reactive Protein level.

urea_units

String. Units for the urea input. Options: "mmol/L" (default) or "mg/dL" (treats input as Blood Urea Nitrogen/BUN).

crp_units

String. Units for the CRP input. Options: "mg/L" (default) or "mg/dL".

References

Knight SR, et al. Risk stratification of patients admitted to hospital with covid-19 using the ISARIC WHO Clinical Characterisation Protocol: development and validation of the 4C Mortality Score. BMJ. 2020;370:m3339. doi:10.1136/bmj.m3339

Examples

# Example 1: High Risk Patient
# 75yo Male, 2 comorbidities, RR 22, O2 91%, GCS 15, High Urea/CRP
isaric_4c_mortality(
  age = 75, sex = "male", comorbidities = 2,
  resp_rate = 22, o2_sat = 91, gcs = 15,
  urea = 15, crp = 120, urea_units = "mmol/L", crp_units = "mg/L"
)

# Example 2: Low Risk Patient
# 45yo Female, 0 comorbidities, Normal vitals and labs
isaric_4c_mortality(
  age = 45, sex = "female", comorbidities = 0,
  resp_rate = 16, o2_sat = 98, gcs = 15,
  urea = 4, crp = 10, urea_units = "mmol/L", crp_units = "mg/L"
)