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CMAAO Coronavirus Facts and Myth Buster: Mortality Score

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Dr KK Aggarwal    19 September 2020

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.

  1. 0 – 3: Low risk of mortality
  2. 4 to 8: Intermediate risk
  3. 9 to 14: High risk
  4. ≥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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