Performance of the CCEDRRN COVID-19 Mortality Score to rule out and rule in in-hospital mortality at various cut-off values in the combined derivation and validation cohorts, and the predicted mortality risk for each value based on the CCEDRRN COVID-19 Mortality Score*
| Score | No. (%) of visits n = 9605 | Sensitivity (95% CI), % | Specificity (95% CI), % | Negative LR | Positive LR | PPV, % | NPV, % | Mortality rate, % | Score | Predicted risk with score |
|---|---|---|---|---|---|---|---|---|---|---|
| Rule out | ||||||||||
| ≤ −1 | 178 (1.8) | 100.0 (99.4–100.0) | 2.0 (1.7–2.3) | 0.0 | 1.0 | 6.6 | 100 | 0.0 | −1 | 0.0001 |
| ≤ 0 | 825 (8.6) | 100.0 (99.4–100.0) | 9.2 (8.6–9.8) | 0.0 | 1.1 | 7.0 | 100 | 0.0 | 0 | 0.0001 |
| ≤ 1 | 1499 (15.6) | 100.0 (99.4–100.0) | 16.7 (15.9–17.5) | 0.0 | 1.2 | 7.6 | 100 | 0.0 | 1 | 0.0002 |
| ≤ 2 | 1926 (20.0) | 100.0 (99.4–100.0) | 21.4 (20.6–22.3) | 0.0 | 1.3 | 8.0 | 100 | 0.0 | 2 | 0.0004 |
| ≤ 3 | 2420 (25.2) | 100.0 (99.4–100.0) | 26.9 (26.0–27.9) | 0.0 | 1.4 | 8.6 | 100 | 0.0 | 3 | 0.0008 |
| ≤ 4 | 2910 (30.3) | 100.0 (99.4–100.0) | 32.4 (31.4–33.4) | 0.0 | 1.5 | 9.2 | 100 | 0.0 | 4 | 0.0016 |
| ≤ 5 | 3685 (38.4) | 99.8 (99.1–100.0) | 41.0 (40.0–42.0) | 0.0 | 1.7 | 10.4 | 100 | 0.0 | 5 | 0.0031 |
| ≤ 6 | 4563 (47.5) | 99.0 (97.9–99.6) | 50.7 (49.7–51.7) | 0.0 | 2.0 | 12.1 | 99.9 | 0.1 | 6 | 0.0058 |
| ≤ 7 | 5497 (57.2) | 97.4 (95.8–98.5) | 61.0 (60.0–62.0) | 0.0 | 2.5 | 14.7 | 99.7 | 0.3 | 7 | 0.0112 |
| ≤ 8 | 6410 (66.7) | 94.0 (91.8–95.7) | 70.9 (70.0–71.9) | 0.1 | 3.2 | 18.2 | 99.4 | 0.6 | 8 | 0.0212 |
| ≤ 9 | 7276 (75.8) | 88.5 (85.7–90.9) | 80.2 (79.3–81.0) | 0.1 | 4.5 | 23.5 | 99.0 | 1.0 | 9 | 0.0399 |
| ≤ 10 | 7974 (83.0) | 77.7 (74.2–80.9) | 87.2 (86.5–87.9) | 0.3 | 6.1 | 29.4 | 98.3 | 1.7 | 10 | 0.0739 |
| Rule in | ||||||||||
| ≥ 10 | 2329 (24.2) | 88.5 (85.7–90.9) | 80.2 (79.3–81.0) | 0.1 | 4.5 | 23.5 | 99.0 | 23.5 | – | – |
| ≥ 11 | 1631 (17.0) | 77.7 (74.2–80.9) | 87.2 (86.5–87.5) | 0.3 | 6.1 | 29.4 | 98.3 | 29.4 | 11 | 0.1327 |
| ≥ 12 | 1083 (11.3) | 65.0 (61.1–65.0) | 92.4 (91.9–93.0) | 0.4 | 8.6 | 37.1 | 97.5 | 37.1 | 12 | 0.2271 |
| ≥ 13 | 604 (6.3) | 46.3 (42.3–50.3) | 96.5 (96.1–96.8) | 0.6 | 13.1 | 47.4 | 96.3 | 47.4 | 13 | 0.3605 |
| ≥ 14 | 276 (2.9) | 28.2 (24.6–31.9) | 98.9 (98.6–99.1) | 0.7 | 24.8 | 63.0 | 95.2 | 63.0 | 14 | 0.5197 |
| ≥ 15 | 100 (1.0) | 13.1 (10.5–16.0) | 99.8 (99.7–99.9) | 0.9 | 62.0 | 81.0 | 94.4 | 81.0 | 15 | 0.6750 |
| ≥ 16 | 29 (0.3) | 4.4 (2.9–6.3) | 100.0 (99.9–100.0) | 1.0 | 196.3 | 93.1 | 93.8 | 93.1 | 16 | 0.7995 |
| ≥ 17 | 5 (0.0) | 0.8 (0.3–1.9) | 100.0 (100.0) | 1.0 | – | 100.0 | 93.6 | 100.0 | 17 | 0.8844 |
Note: CCEDRRN = Canadian COVID-19 Emergency Department Rapid Response Network, CI = confidence interval, LR = likelihood ratio, NPV = negative predictive value, PPV = positive predictive value.
↵* Predicted risk = exp (−9.048 + 0.652 * CCMS)/(1 + exp [−9.049 + 0.652 * CCMS]), where CCMS = CCEDRRN COVID-19 Mortality Score.