External validation of geriatric influenza death score: A multicenter study

Abstract

The Geriatric Influenza Death (GID) score was developed to help decision making in older patients with influenza in the emergency department (ED), but external validation is unavailable. Thus, we conducted a study was to fill the data gap. We recruited all older patients (≥65 years) who visited the ED of three hospitals between 2009 and 2018. Demographic data and clinical characteristics were retrospectively collected. Discrimination, goodness of fit, and performance of the GID score were evaluated. Of the 5,508 patients (121 died) with influenza, the mean age was 76.6±7.4 (standard deviation) years, and 49.3% were males. The GID score was higher in the mortality group (1.7±1.1 vs. 0.8±0.8, p <0.01). With 0 as the reference, the odds ratio for morality with score of 1, 2 and ≥3 was 3.08 (95% confidence interval [CI]: 1.66-5.71), 6.69 (95% CI: 3.52-12.71), and 23.68 (95% CI: 11.95-46.93), respectively. The area under the curve was 0.722 (95% CI: 0.677-0.766), and the Hosmer- Lemeshow goodness of fit test was 1.000. The GID score had excellent negative predictive values with different cut-offs. The GID score had good external validity, and further studies are warranted for wider application.