tetano
Editor, Senior Moderator
Int J Infect Dis
. 2021 Jul 23;S1201-9712(21)00605-6.
doi: 10.1016/j.ijid.2021.07.049. Online ahead of print.
ABC [SUB]2[/SUB]-SPH risk score for in-hospital mortality in COVID-19 patients: development, external validation and comparison with other available scores
Milena S Marcolino[SUP] 1 [/SUP], Magda C Pires[SUP] 2 [/SUP], Lucas Emanuel F Ramos[SUP] 3 [/SUP], Rafael T Silva[SUP] 4 [/SUP], Luana M Oliveira[SUP] 5 [/SUP], Rafael L R Carvalho[SUP] 6 [/SUP], Rodolfo Lucas S Mourato[SUP] 7 [/SUP], Adrián Sánchez-Montalvá[SUP] 8 [/SUP], Berta Raventós[SUP] 9 [/SUP], Fernando Anschau[SUP] 10 [/SUP], José Miguel Chatkin[SUP] 11 [/SUP], Matheus C A Nogueira[SUP] 12 [/SUP], Milton H Guimarães Júnior[SUP] 13 [/SUP], Giovanna G Vietta[SUP] 14 [/SUP], Helena Duani[SUP] 15 [/SUP], Daniela Ponce[SUP] 16 [/SUP], Patricia K Ziegelmann[SUP] 17 [/SUP], Luís C Castro[SUP] 18 [/SUP], Karen B Ruschel[SUP] 19 [/SUP], Christiane C R Cimini[SUP] 20 [/SUP], Saionara C Francisco[SUP] 21 [/SUP], Maiara A Floriani[SUP] 22 [/SUP], Guilherme F Nascimento[SUP] 23 [/SUP], Bárbara L Farace[SUP] 24 [/SUP], Luanna S Monteiro[SUP] 25 [/SUP], Maira V R Souza-Silva[SUP] 26 [/SUP], Thais L S Sales[SUP] 27 [/SUP], Karina Paula M P Martins[SUP] 28 [/SUP], Israel J Borges do Nascimento[SUP] 29 [/SUP], Tatiani O Fereguetti[SUP] 30 [/SUP], Daniel T M O Ferrara[SUP] 31 [/SUP], Fernando A Botoni[SUP] 32 [/SUP], Ana Paula B S Etges[SUP] 33 [/SUP], Eric Boersma[SUP] 34 [/SUP], Carisi A Polanczyk[SUP] 35 [/SUP], Alexandre V Schwarzbold[SUP] 36 [/SUP], Amanda O Maurílio[SUP] 37 [/SUP], Ana Luiza B A Scotton[SUP] 38 [/SUP], André P Weber[SUP] 39 [/SUP], André S M Costa[SUP] 40 [/SUP], Andressa B Glaeser[SUP] 41 [/SUP], Angélica Aparecida C Madureira[SUP] 42 [/SUP], Angelinda R Bhering[SUP] 43 [/SUP], Bruno Mateus de Castro[SUP] 44 [/SUP], Carla Thais C A da Silva[SUP] 45 [/SUP], Carolina M Ramos[SUP] 46 [/SUP], Caroline D Gomes[SUP] 47 [/SUP], Cíntia A de Carvalho[SUP] 48 [/SUP], Daniel V Silveira[SUP] 49 [/SUP], Edilson Cezar[SUP] 50 [/SUP], Elayne C Pereira[SUP] 51 [/SUP], Emanuele Marianne S Kroger[SUP] 52 [/SUP], Felipe B Vallt[SUP] 53 [/SUP], Fernanda B Lucas[SUP] 54 [/SUP], Fernando G Aranha[SUP] 55 [/SUP], Frederico Bartolazzi[SUP] 56 [/SUP], Gabriela P Crestani[SUP] 57 [/SUP], Gisele A N Bastos[SUP] 58 [/SUP], Glícia Cristina de C Madeira[SUP] 59 [/SUP], Helena Carolina Noal[SUP] 60 [/SUP], Heloisa R Vianna[SUP] 61 [/SUP], Henrique C Guimarães[SUP] 62 [/SUP], Isabela M Gomes[SUP] 63 [/SUP], Israel M Romero[SUP] 64 [/SUP], Joanna D L Batista[SUP] 65 [/SUP], Joice C de Alvarenga[SUP] 66 [/SUP], Júlia D S S Guimarães[SUP] 67 [/SUP], Júlia D P de Morais[SUP] 68 [/SUP], Juliana M Rugolo[SUP] 69 [/SUP], Karen Cristina J R Pontes[SUP] 70 [/SUP], Kauane Aline M Dos Santos[SUP] 71 [/SUP], Leonardo S de Oliveira[SUP] 72 [/SUP], Lílian S Pinheiro[SUP] 73 [/SUP], Liliane S Pacheco[SUP] 74 [/SUP], Lucas de D Sousa[SUP] 75 [/SUP], Luciana S F Couto[SUP] 76 [/SUP], Luciane Kopittke[SUP] 77 [/SUP], Luis Cesar S de Moura[SUP] 78 [/SUP], Luisa Elem A Santos[SUP] 79 [/SUP], Máderson A S Cabral[SUP] 80 [/SUP], Maíra D Souza[SUP] 81 [/SUP], Marcela G T Tofani[SUP] 82 [/SUP], Marcelo Carneiro[SUP] 83 [/SUP], Maria Angélica P Ferreira[SUP] 84 [/SUP], Maria Aparecida C Bicalho[SUP] 85 [/SUP], Maria Clara P B Lima[SUP] 86 [/SUP], Mariana F Godoy[SUP] 87 [/SUP], Marilia M A Cardoso[SUP] 88 [/SUP], Meire P Figueiredo[SUP] 89 [/SUP], Natália C S Sampaio[SUP] 90 [/SUP], Natália L Rangel[SUP] 91 [/SUP], Natália T Crespo[SUP] 92 [/SUP], Neimy R de Oliveira[SUP] 93 [/SUP], Pedro L Assaf[SUP] 94 [/SUP], Petrônio José de L Martelli[SUP] 95 [/SUP], Rafaela S C Almeida[SUP] 96 [/SUP], Raphael C Martins[SUP] 97 [/SUP], Raquel Lutkmeier[SUP] 98 [/SUP], Reginaldo Aparecido Valacio[SUP] 99 [/SUP], Renan G Finger[SUP] 100 [/SUP], Ricardo B Cardoso[SUP] 101 [/SUP], Roberta Pozza[SUP] 102 [/SUP], Roberta X Campos[SUP] 103 [/SUP], Rochele M Menezes[SUP] 104 [/SUP], Roger M de Abreu[SUP] 105 [/SUP], Rufino de F Silva[SUP] 106 [/SUP], Silvana M M Guimarães[SUP] 107 [/SUP], Silvia F Araújo[SUP] 108 [/SUP], Susany Anastácia Pereira[SUP] 109 [/SUP], Talita F Oliveira[SUP] 110 [/SUP], Tatiana Kurtz[SUP] 111 [/SUP], Thainara C de Oliveira[SUP] 112 [/SUP], Thaíza Simônia M A Araújo[SUP] 113 [/SUP], Thulio Henrique O Diniz[SUP] 114 [/SUP], Veridiana B Dos Santos[SUP] 115 [/SUP], Virginia Mara R Gomes[SUP] 116 [/SUP], Vitor Augusto L do Vale[SUP] 117 [/SUP], Yuri C Ramires[SUP] 118 [/SUP]
Affiliations
Abstract
Objectives: The majority of available scores to assess mortality risk of coronavirus disease 19 (COVID-19) patients in the emergency department have high risk of bias. Therefore, our aim was 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 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.
Results: Median (25th-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, SpO[SUB]2[/SUB]/FiO[SUB]2[/SUB] ratio, platelet count and heart rate. The model had high discriminatory value (AUROC 0.844, 95% CI 0.829 to 0.859), which was confirmed in the Brazilian (0.859 [95% CI 0.833 to 0.885]) and Spanish (0.894 [95% CI 0.870 to 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: We designed and validated an easy-to-use rapid scoring system based on characteristics of COVID-19 patients commonly available at hospital presentation, for early stratification for in-hospital mortality risk of patients with COVID-19.
Keywords: COVID-19; SARS-CoV-2; hospitalizations; mortality; prognosis; risk factors; score.
. 2021 Jul 23;S1201-9712(21)00605-6.
doi: 10.1016/j.ijid.2021.07.049. Online ahead of print.
ABC [SUB]2[/SUB]-SPH risk score for in-hospital mortality in COVID-19 patients: development, external validation and comparison with other available scores
Milena S Marcolino[SUP] 1 [/SUP], Magda C Pires[SUP] 2 [/SUP], Lucas Emanuel F Ramos[SUP] 3 [/SUP], Rafael T Silva[SUP] 4 [/SUP], Luana M Oliveira[SUP] 5 [/SUP], Rafael L R Carvalho[SUP] 6 [/SUP], Rodolfo Lucas S Mourato[SUP] 7 [/SUP], Adrián Sánchez-Montalvá[SUP] 8 [/SUP], Berta Raventós[SUP] 9 [/SUP], Fernando Anschau[SUP] 10 [/SUP], José Miguel Chatkin[SUP] 11 [/SUP], Matheus C A Nogueira[SUP] 12 [/SUP], Milton H Guimarães Júnior[SUP] 13 [/SUP], Giovanna G Vietta[SUP] 14 [/SUP], Helena Duani[SUP] 15 [/SUP], Daniela Ponce[SUP] 16 [/SUP], Patricia K Ziegelmann[SUP] 17 [/SUP], Luís C Castro[SUP] 18 [/SUP], Karen B Ruschel[SUP] 19 [/SUP], Christiane C R Cimini[SUP] 20 [/SUP], Saionara C Francisco[SUP] 21 [/SUP], Maiara A Floriani[SUP] 22 [/SUP], Guilherme F Nascimento[SUP] 23 [/SUP], Bárbara L Farace[SUP] 24 [/SUP], Luanna S Monteiro[SUP] 25 [/SUP], Maira V R Souza-Silva[SUP] 26 [/SUP], Thais L S Sales[SUP] 27 [/SUP], Karina Paula M P Martins[SUP] 28 [/SUP], Israel J Borges do Nascimento[SUP] 29 [/SUP], Tatiani O Fereguetti[SUP] 30 [/SUP], Daniel T M O Ferrara[SUP] 31 [/SUP], Fernando A Botoni[SUP] 32 [/SUP], Ana Paula B S Etges[SUP] 33 [/SUP], Eric Boersma[SUP] 34 [/SUP], Carisi A Polanczyk[SUP] 35 [/SUP], Alexandre V Schwarzbold[SUP] 36 [/SUP], Amanda O Maurílio[SUP] 37 [/SUP], Ana Luiza B A Scotton[SUP] 38 [/SUP], André P Weber[SUP] 39 [/SUP], André S M Costa[SUP] 40 [/SUP], Andressa B Glaeser[SUP] 41 [/SUP], Angélica Aparecida C Madureira[SUP] 42 [/SUP], Angelinda R Bhering[SUP] 43 [/SUP], Bruno Mateus de Castro[SUP] 44 [/SUP], Carla Thais C A da Silva[SUP] 45 [/SUP], Carolina M Ramos[SUP] 46 [/SUP], Caroline D Gomes[SUP] 47 [/SUP], Cíntia A de Carvalho[SUP] 48 [/SUP], Daniel V Silveira[SUP] 49 [/SUP], Edilson Cezar[SUP] 50 [/SUP], Elayne C Pereira[SUP] 51 [/SUP], Emanuele Marianne S Kroger[SUP] 52 [/SUP], Felipe B Vallt[SUP] 53 [/SUP], Fernanda B Lucas[SUP] 54 [/SUP], Fernando G Aranha[SUP] 55 [/SUP], Frederico Bartolazzi[SUP] 56 [/SUP], Gabriela P Crestani[SUP] 57 [/SUP], Gisele A N Bastos[SUP] 58 [/SUP], Glícia Cristina de C Madeira[SUP] 59 [/SUP], Helena Carolina Noal[SUP] 60 [/SUP], Heloisa R Vianna[SUP] 61 [/SUP], Henrique C Guimarães[SUP] 62 [/SUP], Isabela M Gomes[SUP] 63 [/SUP], Israel M Romero[SUP] 64 [/SUP], Joanna D L Batista[SUP] 65 [/SUP], Joice C de Alvarenga[SUP] 66 [/SUP], Júlia D S S Guimarães[SUP] 67 [/SUP], Júlia D P de Morais[SUP] 68 [/SUP], Juliana M Rugolo[SUP] 69 [/SUP], Karen Cristina J R Pontes[SUP] 70 [/SUP], Kauane Aline M Dos Santos[SUP] 71 [/SUP], Leonardo S de Oliveira[SUP] 72 [/SUP], Lílian S Pinheiro[SUP] 73 [/SUP], Liliane S Pacheco[SUP] 74 [/SUP], Lucas de D Sousa[SUP] 75 [/SUP], Luciana S F Couto[SUP] 76 [/SUP], Luciane Kopittke[SUP] 77 [/SUP], Luis Cesar S de Moura[SUP] 78 [/SUP], Luisa Elem A Santos[SUP] 79 [/SUP], Máderson A S Cabral[SUP] 80 [/SUP], Maíra D Souza[SUP] 81 [/SUP], Marcela G T Tofani[SUP] 82 [/SUP], Marcelo Carneiro[SUP] 83 [/SUP], Maria Angélica P Ferreira[SUP] 84 [/SUP], Maria Aparecida C Bicalho[SUP] 85 [/SUP], Maria Clara P B Lima[SUP] 86 [/SUP], Mariana F Godoy[SUP] 87 [/SUP], Marilia M A Cardoso[SUP] 88 [/SUP], Meire P Figueiredo[SUP] 89 [/SUP], Natália C S Sampaio[SUP] 90 [/SUP], Natália L Rangel[SUP] 91 [/SUP], Natália T Crespo[SUP] 92 [/SUP], Neimy R de Oliveira[SUP] 93 [/SUP], Pedro L Assaf[SUP] 94 [/SUP], Petrônio José de L Martelli[SUP] 95 [/SUP], Rafaela S C Almeida[SUP] 96 [/SUP], Raphael C Martins[SUP] 97 [/SUP], Raquel Lutkmeier[SUP] 98 [/SUP], Reginaldo Aparecido Valacio[SUP] 99 [/SUP], Renan G Finger[SUP] 100 [/SUP], Ricardo B Cardoso[SUP] 101 [/SUP], Roberta Pozza[SUP] 102 [/SUP], Roberta X Campos[SUP] 103 [/SUP], Rochele M Menezes[SUP] 104 [/SUP], Roger M de Abreu[SUP] 105 [/SUP], Rufino de F Silva[SUP] 106 [/SUP], Silvana M M Guimarães[SUP] 107 [/SUP], Silvia F Araújo[SUP] 108 [/SUP], Susany Anastácia Pereira[SUP] 109 [/SUP], Talita F Oliveira[SUP] 110 [/SUP], Tatiana Kurtz[SUP] 111 [/SUP], Thainara C de Oliveira[SUP] 112 [/SUP], Thaíza Simônia M A Araújo[SUP] 113 [/SUP], Thulio Henrique O Diniz[SUP] 114 [/SUP], Veridiana B Dos Santos[SUP] 115 [/SUP], Virginia Mara R Gomes[SUP] 116 [/SUP], Vitor Augusto L do Vale[SUP] 117 [/SUP], Yuri C Ramires[SUP] 118 [/SUP]
Affiliations
- PMID: 34311100
- DOI: 10.1016/j.ijid.2021.07.049
Abstract
Objectives: The majority of available scores to assess mortality risk of coronavirus disease 19 (COVID-19) patients in the emergency department have high risk of bias. Therefore, our aim was 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 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.
Results: Median (25th-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, SpO[SUB]2[/SUB]/FiO[SUB]2[/SUB] ratio, platelet count and heart rate. The model had high discriminatory value (AUROC 0.844, 95% CI 0.829 to 0.859), which was confirmed in the Brazilian (0.859 [95% CI 0.833 to 0.885]) and Spanish (0.894 [95% CI 0.870 to 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: We designed and validated an easy-to-use rapid scoring system based on characteristics of COVID-19 patients commonly available at hospital presentation, for early stratification for in-hospital mortality risk of patients with COVID-19.
Keywords: COVID-19; SARS-CoV-2; hospitalizations; mortality; prognosis; risk factors; score.