MuLBSTA Score Accurately Predicts Mortality, Outcomes in Hospitalised Patients With COVID-19
By Nancy Melville
YORK, Me -- October 21, 2020 -- The MuLBSTA score successfully stratified hospitalised patients with coronavirus disease 2019 (COVID-19) pneumonia based on severity, and accurately predicted overall outcome, according to a study presented at the 2020 Virtual Meeting of the American College of CHEST Physicians.
“This score correlated significantly with mortality, ventilator support, and length of stay, which may be used to provide guidance to screen patients and make further clinical decisions,” said Jurgena Tusha MD, Wayne State University, Detroit, Michigan.
“The MuLBSTA score is designed to predict 90-day mortality in patients with viral pneumonia,” explained Dr. Tusha. “We explored the applicability of MuLBSTA score in predicting disease severity and risk of mortality in patients with COVID-19.”
The researchers conducted a chart review of 163 hospitalised patients with COVID-19 pneumonia at a community hospital in Michigan from March 15, 2020, to April 10, 2020. Several clinical characteristics were reviewed, and 6 risk factors were incorporated into the MulBSTA score which included multilobe infiltrate (5 points), absolute lymphocyte count ≤0.8 x 109/L (4 points), bacterial coinfection (4 points), smoking history (previous smoker = 2 points, recent smoker = 3 points), history of hypertension (2 points), and age ≥ 60 years (2 points).
The calculated score was then compared with the primary outcome of mortality and secondary outcomes, which included length of stay and ventilator support. Data collected was then analysed using SPSS, validity of the data was analyzed using regression analysis and receiver operating characteristic curve.
The overall mortality rate was 29.4%, the mortality rate among patients admitted to the intensive care unit was 50.9%, and among patients on ventilators, the mortality rate was 62.8%.
The MuLBSTA score was applied to each patient manually at the time of hospitalisation. The mean MuLBSTA score among patients who survived was 8.67 compared with a mean score of 13.6 among patients who died.
There was a significant positive correlation between the MuLBSTA score and mortality (odds ratio [OR] = 1.37; 95% confidence interval [CI], 1.23-1.53; P = .0001).
The area under the receiver operating characteristic curve of MuLBSTA for predicting in-hospital mortality at time of admission was 0.813.
A positive correlation was also found with ventilator support (P = .0001) and length of stay (r (P = .0001).
A Kaplan Meier survival analysis showed that patients with a MuLBSTA score >12 had a higher risk of mortality (P = .001).
“Further studies are required to validate this study in larger patient cohorts,” noted Dr. Tusha.
[Presentation title: The Mulbsta Score: Predicting Risk of Mortality and Disease Severity in Patients With COVID-19 Pneumonia. Abstract A300]