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

Made available in DSpace on 2022-04-29T08:31:56Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-09-01 Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) 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 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 (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/). Conclusions: 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. Department of Internal Medicine Medical School Universidade Federal de Minas Gerais Telehealth Center University Hospital Universidade Federal de Minas Gerais Institute for Health Technology Assessment IATS/ CNPq)., Rua Ramiro Barcelos, 2359. Prédio 21 | Sala 507 Department of Statistics Universidade Federal de Minas Gerais Center for Research and Graduate Studies in Business Administration Universidade Federal de Minas Gerais Universidade Federal de São João del-Rei Infectious Diseases Department Vall d'Hebron University Hospita Universitat Autònoma de Barcelona Hospital Nossa Senhora da Conceição and Hospital Cristo Redentor Grupo Hospitalar Conceição Pontifícia Universidade Católica do Rio Grande do Sul RGS) Hospital São Lucas PUCRS Rede Mater Dei de Saúde Hospital Márcio Cunha Universidade do Sul de Santa Catarina UNISUL Dissertare Scientific Advice SOS Cardio Hospital Internal Medicine Department University Hospital Universidade Federal de Minas Gerais Faculdade de Medicina de Botucatu Universidade Estadual Paulista Júlio de Mesquita Filho Hospital das Clínicas da Faculdade de Medicina de Botucatu Universidade Federal do Rio Grande do Sul Hospital Bruno Born Research Center of Vale do Taquari. Hospital Mãe de Deus Hospital Universitário de Canoas Mucuri Medical School FAMMUC Universidade Federal dos Vales do Jequitinhonha e Mucuri – UFVJM Hospital Santa Rosalia Hospital Metropolitano Doutor Célio de Castro Hospital Moinhos de Vento Hospital Unimed BH Hospital Risoleta Tolentino Neves Post-graduation Center Medical School Universidade Federal de Minas Gerais Hospital Metropolitano Odilon Behrens Hospital Eduardo de Menezes Universidade FUMEC Hospital Julia Kubitschek Hospital Universitário de Santa Maria Departamento de Medicina Interna Universidade Federal de Santa Maria Hospital São João de Deus Hospital Regional Antônio Dias Faculdade Ciências Médicas de Minas Gerais Hospital de Clínicas de Porto Alegre Universidade Federal do Rio Grande do Sul Faculdade de Ciências Humanas de Curvelo Hospital João XXIII Av. Professor Alfredo Balena Hospital Santo Antônio Hospital Universitário Ciências Médicas Vall d'Hebron University Hospital PROSICS Barcelona Instituto René Rachou-FIOCRUZ Minas. Universidade Federal da Fronteira Sul Hospital Regional do Oeste Pontifícia Universidade Católica de Minas Gerais Hospital Tacchini Centro Universitário de Patos de Minas. RPatos de Minas Hospital Semper Hospital Santa Cruz Universidade de Santa Cruz Fundação Hospitalar do Estado de Minas Gerais – FHEMIG. Universidade Federal de Ouro Preto Hospital das Clínicas da Universidade Federal de Pernambuco Universidade Federal de Pernambuco Centro de Ciências Médicas Centro Universitário de Belo Horizonte UniBH) Erasmus MC University Medical Center Rotterdam Department of Cardiology Faculdade de Medicina de Botucatu Universidade Estadual Paulista Júlio de Mesquita Filho Hospital das Clínicas da Faculdade de Medicina de Botucatu