Frontiers in Medicine (Nov 2023)

Assessment of the ABC2-SPH risk score to predict invasive mechanical ventilation in COVID-19 patients and comparison to other scores

  • Christiane Corrêa Rodrigues Cimini,
  • Christiane Corrêa Rodrigues Cimini,
  • Polianna Delfino-Pereira,
  • Magda Carvalho Pires,
  • Lucas Emanuel Ferreira Ramos,
  • Angélica Gomides dos Reis Gomes,
  • Alzira de Oliveira Jorge,
  • Ariovaldo Leal Fagundes,
  • Bárbara Machado Garcia,
  • Bruno Porto Pessoa,
  • Cíntia Alcantara de Carvalho,
  • Daniela Ponce,
  • Danyelle Romana Alves Rios,
  • Fernando Anschau,
  • Flavia Maria Borges Vigil,
  • Frederico Bartolazzi,
  • Genna Maira Santos Grizende,
  • Giovanna Grunewald Vietta,
  • Giulia Maria dos Santos Goedert,
  • Guilherme Fagundes Nascimento,
  • Heloisa Reniers Vianna,
  • Isabela Muzzi Vasconcelos,
  • Isabela Muzzi Vasconcelos,
  • Joice Coutinho de Alvarenga,
  • José Miguel Chatkin,
  • José Miguel Chatkin,
  • Juliana Machado Rugolo,
  • Karen Brasil Ruschel,
  • Karen Brasil Ruschel,
  • Karen Brasil Ruschel,
  • Liege Barella Zandoná,
  • Luanna Silva Monteiro Menezes,
  • Luís César de Castro,
  • Maíra Dias Souza,
  • Marcelo Carneiro,
  • Maria Aparecida Camargos Bicalho,
  • Maria Aparecida Camargos Bicalho,
  • Maria Izabel Alcântara Cunha,
  • Manuela Furtado Sacioto,
  • Neimy Ramos de Oliveira,
  • Pedro Guido Soares Andrade,
  • Raquel Lutkmeier,
  • Rochele Mosmann Menezes,
  • Antonio Luiz Pinho Ribeiro,
  • Antonio Luiz Pinho Ribeiro,
  • Antonio Luiz Pinho Ribeiro,
  • Milena Soriano Marcolino,
  • Milena Soriano Marcolino,
  • Milena Soriano Marcolino

DOI
https://doi.org/10.3389/fmed.2023.1259055
Journal volume & issue
Vol. 10

Abstract

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BackgroundPredicting the need for invasive mechanical ventilation (IMV) is important for the allocation of human and technological resources, improvement of surveillance, and use of effective therapeutic measures. This study aimed (i) to assess whether the ABC2-SPH score is able to predict the receipt of IMV in COVID-19 patients; (ii) to compare its performance with other existing scores; (iii) to perform score recalibration, and to assess whether recalibration improved prediction.MethodsRetrospective observational cohort, which included adult laboratory-confirmed COVID-19 patients admitted in 32 hospitals, from 14 Brazilian cities. This study was conducted in two stages: (i) for the assessment of the ABC2-SPH score and comparison with other available scores, patients hospitalized from July 31, 2020, to March 31, 2022, were included; (ii) for ABC2-SPH score recalibration and also comparison with other existing scores, patients admitted from January 1, 2021, to March 31, 2022, were enrolled. For both steps, the area under the receiving operator characteristic score (AUROC) was calculated for all scores, while a calibration plot was assessed only for the ABC2-SPH score. Comparisons between ABC2-SPH and the other scores followed the Delong Test recommendations. Logistic recalibration methods were used to improve results and adapt to the studied sample.ResultsOverall, 9,350 patients were included in the study, the median age was 58.5 (IQR 47.0–69.0) years old, and 45.4% were women. Of those, 33.5% were admitted to the ICU, 25.2% received IMV, and 17.8% died. The ABC2-SPH score showed a significantly greater discriminatory capacity, than the CURB-65, STSS, and SUM scores, with potentialized results when we consider only patients younger than 80 years old (AUROC 0.714 [95% CI 0.698–0.731]). Thus, after the ABC2-SPH score recalibration, we observed improvements in calibration (slope = 1.135, intercept = 0.242) and overall performance (Brier score = 0.127).ConclusionThe ABC2-SPHr risk score demonstrated a good performance to predict the need for mechanical ventilation in COVID-19 hospitalized patients under 80 years of age.

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