4C Mortality Score

The 4C Mortality Score is a risk stratification score that predicts in-hospital mortality for hospitalised COVID-19 patients, produced by the ISARIC 4C consortium. It is intended for use by clinicians.

It is designed to be easy-to-use, and require only parameters that are commonly available at hospital presentation.

It is based on a UK cohort of patients, and should not be adopted for routine clinical use in other settings until it has been appropriately validated.

For full details, see the paper introducing the score.

This page is an infographic that visualises risk, based on observed mortality among hospitalised adult COVID19 patients recruited into the ISARIC 4C study in the UK.

How this calculation is done

The calculation is simple, and can be done without even requiring a calculator.

The ISARIC4C score is obtained by adding the scores for each individual variable (see Table 2 of the paper). The contributions to the total score are listed on each button in the form below.

The observed in-hospital mortality for patients with this score in the validation cohort is then given by a lookup table (see Figure 2 of the paper):

4C Mortality Score	Mortality/%
1	0.3
2	0.8
3	2.3
4	4.8
5	7.5
6	7.8
7	11.7
8	14.4
9	19.2
10	22.9
11	26.9
12	32.9
13	40.1
14	44.6
15	51.6
16	59.1
17	66.1
18	75.8
19	77.4
20	82.9
21	87.5

Age (years):

Sex at birth:

Number of comorbidities:

Definition

Chronic cardiac disease; chronic respiratory disease (excluding asthma); chronic renal disease (estimated glomerular filtration rate ≤30); mild-to-severe liver disease; dementia; chronic neurological conditions; connective tissue disease; diabetes mellitus (diet, tablet or insulin-controlled); HIV/AIDS; malignancy; clinician-defined obesity.

Respiratory rate (breaths/minutes):

Peripheral oxygen saturation on room air (%):

Glasgow Coma Scale:

Urea (mmol/L):

CRP (mg/L):

Please select a value for every variable to calculate a mortality score.

What you should do

It is important that everyone follows the Government's advice on Staying alert and safe (social distancing), and on self-isolating if they or someone in their household has symptoms of COVID-19. This is important not only to protect yourself, but also to prevent you from accidentally infecting more vulnerable people.

People who are defined as extremely vulnerable on medical grounds should also follow the government's advice on shielding.

If you think that you might have COVID-19, you should stay at home and consult the NHS Website for advice.