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

2021; Elsevier BV; Volume: 110; Linguagem: Inglês

10.1016/j.ijid.2021.07.049

1878-3511

Milena Soriano Marcolino, Magda Carvalho Pires, Lucas Emanuel Ferreira Ramos, Rafael T. Silva, Luana Martins Oliveira, Rafael Lima Rodrigues de Carvalho, Rodolfo Lucas Silva Mourato, Adrián Sánchez‐Montalvá, Berta Raventós, Fernando Anschau, José Miguel Chatkin, Matheus Carvalho Alves Nogueira, Milton Henriques Guimarães Júnior, Giovanna Grünewald Vietta, Helena Duani, Daniela Ponce, Patrícia Klarmann Ziegelmann, Luís César de Castro, Karen Brasil Ruschel, Christiane Corrêa Rodrigues Cimini, Saionara Cristina Francisco, Maiara Anschau Floriani, Guilherme Fagundes Nascimento, Bárbara Lopes Farace, Luanna S. Monteiro, Maíra Viana Rego Souza-Silva, Thaís Lorenna Souza Sales, Karina Paula Medeiros Prado Martins, Israel Júnior Borges do Nascimento, Tatiani Oliveira Fereguetti, Daniel T. M. O. Ferrara, Fernando Antônio Botoni, Ana Paula Beck da Silva Etges, Alexandre Vargas Schwarzbold, Amanda O. Maurílio, Ana Luiza Bahia Alves Scotton, André P. Weber, André S. Costa, Andressa Barreto Glaeser, Angélica Aparecida Coelho Madureira, Angelinda Rezende Bhering, Bruno Mateus de Castro, Carla Thais C.A. da Silva, Carolina Marques Ramos, Caroline Danubia Gomes, Cíntia Alcântara de Carvalho, Daniel Vitório Silveira, Edilson Cezar, Elayne Crestani Pereira, Emanuele Marianne Souza Kroger, Felipe Barbosa Vallt, Fernanda Barbosa Lucas, Fernando Graça Aranha, Frederico Bartolazzi, Gabriela Petry Crestani, Gisele Alsina Nader Bastos, Glícia Cristina de Castro Madeira, Helena Carolina Noal, Heloísa Reniers Vianna, Henrique Cerqueira Guimarães, Isabela Moraes Gomes, Israel Molina, Joanna d’Arc Lyra Batista, Joice Coutinho de Alvarenga, Júlia di Sabatino Santos Guimarães, Júlia Drumond Parreiras de Morais, Juliana Machado-Rugolo, Karen Cristina J.R. Pontes, Kauane Aline Maciel dos Santos, Leonardo Seixas de Oliveira, Lílian Santos Pinheiro, Liliane Souto Pacheco, Lucas de Deus Sousa, Luciana Siuves Ferreira Couto, Luciane Kopittke, Luis Cesar Souto de Moura, Luísa Elem Almeida Santos, Máderson A.S. Cabral, Maíra Dias Souza, Marcela Gonçalves Trindade Tofani, Marcelo Carneiro, Maria Angélica Pires Ferreira, Maria Aparecida Camargos Bicalho, Maria Clara Pontello Barbosa Lima, Mariana Frizzo de Godoy, Marília Mastrocolla de Almeida Cardoso, Meire Pereira de Figueiredo, Natália C.S. Sampaio, Natália L. Rangel, Natália T. Crespo, Neimy Ramos de Oliveira, Pedro Ledic Assaf, Petrônio José de Lima Martelli, Rafaela Santos Charão de Almeida, Raphael Castro Martins, Raquel Lutkmeier, Reginaldo Aparecido Valácio, Renan Goulart Finger, Ricardo Bertoglio Cardoso, Roberta Pozza, Roberta Xavier Campos, Rochele Mosmann Menezes, Roger Mendes de Abreu, Rufino de F. Silva, Silvana Mangeon Mereilles Guimarães, Silvia Ferreira Araújo, Susany Anastácia Pereira, Talita Fischer Oliveira, Tatiana Kurtz, Thainara Conceição de Oliveira, Thaíza Simônia M.A. Araújo, Thulio Henrique Oliveira Diniz, Veridiana Baldon dos Santos, Virgínia Mara Reis Gomes, Vitor Augusto Lima do Vale, Yuri Carlotto Ramires, Eric Boersma, Carísi Anne Polanczyk,

Sepsis Diagnosis and Treatment

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.Consecutive patients (≥ 18 years) with confirmed COVID-19 admitted to the participating hospitals 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.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 mortality. 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/).An easy-to-use rapid scoring system based on characteristics of COVID-19 patients commonly available at hospital presentation was designed and validated for early stratification of in-hospital mortality risk of patients with COVID-19.