EVALUation of National Implementation of the ISARIC 4C Mortality Score in United Kingdom hospitals


Project status

Open to enrolment as of 3rd June 2021!

Please express your interest by emailing value4c@nitcollaborative.org.uk.



This is a national project aiming to gain a greater understanding of the use of the 4C mortality score in UK hospitals.

The study comprises two parts:

Part 1: An observational, cross-sectional study involving collection of basic information on the existing COVID-19 guidance/protocol at your hospital.

Part 2: A retrospective cohort study to investigate whether or not the 4C mortality score was documented in the casenotes of patients presenting to hospital with COVID-19 from 11th to 24thJanuary 2021.

Investigators who submit part 1 alone will be eligible for a certificate of audit participation. Investigators who submit both parts 1 and 2 will be eligible for citable authorship as per NITCAR’s authorship policy.



The 4C mortality score (ISARIC 4C consortium) has been demonstrated to be a highly effective tool to assess in-hospital mortality risk in COVID-19 patients. Based on eight easy-to-access variables that include patient characteristics, physiological and blood parameters on admission, the 4C score outperformed 15 pre-existing prognostic scores in predicting mortality risk in patients with COVID- 19(1).

Anecdotal evidence suggests that hospitals have started to incorporate the 4C mortality score into their COVID-19 guidance, but no studies have assessed this.

In our study, we will be collecting information about how the 4C mortality score has been incorporated into hospital COVID-19 guidance. We will also be investigating whether or not the 4C mortality score was documented in patients’ case notes during the January 2021 wave of COVID-19.

We hope to use this information to provide clinicians with key insights into the use of the 4C score ahead of future waves of COVID-19.



Any infection doctor or junior doctor currently working in the UK with an interest in infection specialties is invited to contribute.



We are recruiting sites NOW as of 3rd June 2021!!

We aim to have data collection completed by the end of August 2021- we would welcome expressions of interest ASAP!


How do I get involved?

Email us at value4c@nitcollaborative.org.uk.


Trainee Leads: Dr Andrew Blunsum, Dr Jonathan Perkins

Principal investigator: Dr Antonia Ho