CMAAO Coronavirus Facts and Myth Buster: Mortality Score

With input from Dr Monica Vasudev

4C mortality score predicts mortality in hospitalized patients with COVID-19

4C (Coronavirus Clinical Characterisation Consortium) Mortality Score can be used to accurately categorize patients hospitalized with coronavirus disease 2019 (COVID-19) as being at low, intermediate, high, or very high risk of death, according to a study published in The BMJ.

The 4C Mortality Score uses 8 variables — age, sex, number of comorbidities, respiratory rate, peripheral oxygen saturation, level of consciousness, urea level, and C reactive protein — to calculate a score that ranges from 0 to 21 points.

0 – 3: Low risk of mortality
4 to 8: Intermediate risk
9 to 14: High risk
≥15: Highest mortality risk.
[British Medical Journal]

Variable

4C Mortality Score

Age (years)

 <50 —  50-59 +2  60-69 +4  70-79 +6  ≥80 +7 Sex at birth  Female —  Male +1 No of comorbidities*  0 —  1 +1  ≥2 +2 Respiratory rate (breaths/min)  <20 —  20-29 +1  ≥30 +2 Peripheral oxygen saturation on room air (%)  ≥92 —  <92 +2 Glasgow coma scale score  15 —  <15 +2 Urea (mmol/L)  ≤7 ( 20 mg/dL) —  7-14 +1  >14 ( 40 mg/dL)

+3

C-reactive protein (mg/dL)

 <50 —  50-99 +1  ≥100 +2 * Comorbidities were defined by using Charlson comorbidity index, with the addition of clinician defined obesity. Dr KK Aggarwal President CMAAO, HCFI and Past National President IMA

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