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. 2022 Jul 15;61(14):2135-2141.
doi: 10.2169/internalmedicine.9262-21. Epub 2022 May 14.

A Convenient Risk Prediction Score for COVID-19 for Determining Whether or Not Hospitalization Is Recommended: Kanagawa Admission Priority Assessment Score

Nobumasa Tamura  1   2 , Shota Uchiyama  1   2 , Saiko Nishioka  1   2 , Kentaro Tamura  1   2 , Masahiro Yoshida  1 , Zenya Saito  1   2 , Kazuyoshi Kuwano  2
Affiliations

A Convenient Risk Prediction Score for COVID-19 for Determining Whether or Not Hospitalization Is Recommended: Kanagawa Admission Priority Assessment Score

Nobumasa Tamura et al. Intern Med. .

Abstract

Objective Coronavirus disease 2019 (COVID-19) has caused a collapse of the medical care system, with effective triage proving vital. The Kanagawa admission priority assessment score, version-1 (KAPAS-1) and version-2 (KAPAS-2), was developed to determine the need for hospitalization. Patients with a high KAPAS (≥5) are recommended for hospitalization. We retrospectively investigated the correlation between the KAPAS and oxygen requirement during hospitalization. Methods We collected the clinical data of COVID-19 patients admitted between February 5 and December 6, 2020. Patients were divided into two groups: those who required oxygen therapy during hospitalization (OXY) and those who did not (NOXY). We assessed the correlations between the groups and KAPAS-1 and KAPAS-2. Results Overall, 117 COVID-19 patients were analyzed, including 20 OXY and 97 NOXY and 54 high KAPAS-1 and 63 high KAPAS-2. The median KAPAS-1 and KAPAS-2 were significantly higher in OXY than in NOXY (6.5 vs. 3, and 9 vs. 4, respectively). The areas under the receiver operating characteristic curves of KAPAS-1 and KAPAS-2 for oxygen requirement were 0.777 and 0.825, respectively, and the maximum values of Youden's index were 4 and 6, respectively. The proportions of high KAPAS-1 and high KAPAS-2 were significantly higher in OXY than in NOXY (90.0% vs. 37.1%, and 90.0% vs. 46.4%, respectively). Conclusion The KAPAS was significantly correlated with oxygen requirement. Furthermore, the KAPAS may be useful for deciding which patients are most likely to require hospitalization and for selecting non-hospitalized patients who should be carefully monitored.

Keywords: COVID-19; predictive score; severity; worsening.

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Conflict of interest statement

The authors state that they have no Conflict of Interest (COI).

Figures

Figure 1.
Figure 1.
Box-and-whisker plots of KAPAS by oxygen requirement. A: KAPAS-1, B: KAPAS-2. KAPAS: Kanagawa admission priority assessment score
Figure 2.
Figure 2.
Receiver operating characteristic curves of KAPAS for oxygen requirement. A: KAPAS-1, B: KAPAS-2. AUC: area under the curve, CI: confidence interval, KAPAS: Kanagawa admission priority assessment score
Figure 3.
Figure 3.
Calibration plots for predicting oxygen requirement. A: KAPAS-1, B: KAPAS-2. KAPAS: Kanagawa admission priority assessment score
See this image and copyright information in PMC

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