ABC2-SPH risk score for in-hospital mortality in COVID-19 patients: development, external validation and comparison with other available scores

Objectives: The majority of available scores to assess mortality risk of coronavirus disease 2019 (COVID-19) patients in the emergency department have high risk of bias. Therefore, this cohort aimed to develop and validate a score at hospital admission for predicting in-hospital mortality in COVID-1...

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Autores: Felipe b. Vallt, Fernanda b. Lucas, Fernando g. Aranha, Frederico Bartolazzi, Gabriela p. Crestani, Gisele A.n. Bastos, Glícia Cristina de c. Madeira, Helena Carolina Noal, Heloisa r. Vianna, Rafael L.r. Carvalho, Henrique c. Guimarães, Isabela m. Gomes, Israel Molina, Joanna D'arc l. Batista, Joice c. de Alvarenga, Júlia D.s.s. Guimarães, Júlia D.p. de Morais, Milena S.marcolino, Fernando Anschau, Roberta Pozza, Roberta x. Campos, Rochele m. Menezes, Roger m. de Abreu, Rufino de f. Silva, Silvana M.m. Guimarães, Silvia f. Araújo, Susany Anastácia Pereira, Talita f. Oliveira, Juliana m. Rugolo, Karen Cristina J.r. Pontes, Kauane Aline m. Dos Santos, Rodolfo Lucas s. Mourato, Leonardo s. de Oliveira, Lílian s. Pinheiro, Liliane s. Pacheco, Lucas de d. Sousa, Luciana S.f. Couto, Luciane Kopittke, Maria Aparecida c. Bicalho, Luis Cesar s. de Moura, Luisa Elem a. Santos, Máderson A.s. Cabral, Maíra d. Souza, Adrián Sánchez-montalvá, Marcela G.t. Tofani, Marcelo Carneiro, Maria Angélica p. Ferreira, Maria Clara P.b. Lima, Mariana f. Godoy, Marilia M.a. Cardoso, Meire p. Figueiredo, Natália C.s. Sampaio, Natália l. Rangel, Berta Raventós, Natália t. Crespo, Neimy r. de Oliveira, Tatiana Kurtz, Pedro l. Assaf, Petrônio José de l. Martelli, Rafaela S.c. Almeida, Raphael c. Martins, Raquel Lutkmeier, Reginaldo Aparecido Valacio, Renan g. Finger, Ricardo b. Cardoso, José Miguel Chatkin, Thainara c. de Oliveira, Thaíza Simônia M.a. Araújo, Thulio Henrique o. Diniz, Veridiana b. Dos Santos, Virginia Mara r. Gomes, Vitor Augusto l. do Vale, Yuri c. Ramires, Eric Boersma, Carisi a. Polanczyk, Matheus Carvalho Alves Nogueira, Milton h. Guimarães-júnior, Giovanna g. Vietta, Helena Duani, Daniela Ponce, Patricia k. Ziegelmann, Luís c. Castro, Karen b. Ruschel, Christiane C.r. Cimini, Saionara c. Francisco, Maiara a. Floriani, Guilherme f. Nascimento, Bárbara l. Farace, Luanna s. Monteiro, Maira V.r. Souza-silva, Thais L.s. Sales, Karina Paula M.p. Martins, Israel j. Borges do Nascimento, Lucas Emanuel f. Ramos, Tatiani o. Fereguetti, Daniel T.m.o. Ferrara, Fernando a. Botoni, Ana Paula B.s. Etges, Alexandre v. Schwarzbold, Amanda o. Maurílio, Ana Luiza B.a. Scotton, André p. Weber, André S.m. Costa, Andressa b. Glaeser, Rafael t. Silva, Angélica Aparecida c. Madureira, Angelinda r. Bhering, Bruno Mateus de Castro, Carla Thais C.a. da Silva, Carolina m. Ramos, Caroline d. Gomes, Cíntia a. de Carvalho, Daniel v. Silveira, Edilson Cezar, Magda c. Pires, Elayne c. Pereira, Luana m. Oliveira, Emanuele Marianne s. Kroger
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2021
País:Brasil
Institución:Universidade Federal de Minas Gerais (UFMG)
Repositorio:Repositório Institucional da UFMG
Idioma:inglés
OAI Identifier:oai:repositorio.ufmg.br:1843/57557
Acceso en línea:https://doi.org/10.1016/j.ijid.2021.07.049
http://hdl.handle.net/1843/57557
https://orcid.org/0000-0001-9345-018X
Access Level:acceso abierto
Palabra clave:COVID-19
SARS-CoV-2
Mortality
Prognosis
Risk factors
Hospitalizations
Mortalidade
Prognóstico
Fatores de risco
Hospitalizações
Descripción
Sumario:Objectives: The majority of available scores to assess mortality risk of coronavirus disease 2019 (COVID-19) patients in the emergency department have high risk of bias. Therefore, this cohort aimed to develop and validate a score at hospital admission for predicting in-hospital mortality in COVID-19 patients and to compare this score with other existing ones.Methods: Consecutive patients (≥ 18 years) with confirmed COVID-19 admitted to the participating hos pitals were included. Logistic regression analysis was performed to develop a prediction model for in hospital mortality, based on the 3978 patients admitted between March–July, 2020. The model was validated in the 1054 patients admitted during August–September, as well as in an external cohort of 474 Spanish patients.Results: Median (25–75th percentile) age of the model-derivation cohort was 60 (48–72) years, and in hospital mortality was 20.3%. The validation cohorts had similar age distribution and in-hospital mor tality. Seven significant variables were included in the risk score: age, blood urea nitrogen, number of comorbidities, C-reactive protein, SpO2/FiO2 ratio, platelet count, and heart rate. The model had high discriminatory value (AUROC 0.844, 95% CI 0.829–0.859), which was confirmed in the Brazilian (0.859 [95% CI 0.833–0.885]) and Spanish (0.894 [95% CI 0.870–0.919]) validation cohorts, and displayed better discrimination ability than other existing scores. It is implemented in a freely available online risk calculator (https://abc2sph.com/). Conclusions: An easy-to-use rapid scoring system based on characteristics of COVID-19 patients com monly available at hospital presentation was designed and validated for early stratification of in-hospital mortality risk of patients with COVID-19.

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