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. 2023 Nov 16:10:1259055.
doi: 10.3389/fmed.2023.1259055. eCollection 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  1   2 , Polianna Delfino-Pereira  3 , Magda Carvalho Pires  4 , Lucas Emanuel Ferreira Ramos  4 , Angélica Gomides Dos Reis Gomes  5 , Alzira de Oliveira Jorge  6 , Ariovaldo Leal Fagundes  7 , Bárbara Machado Garcia  8 , Bruno Porto Pessoa  9 , Cíntia Alcantara de Carvalho  10 , Daniela Ponce  11 , Danyelle Romana Alves Rios  12 , Fernando Anschau  13 , Flavia Maria Borges Vigil  14 , Frederico Bartolazzi  15 , Genna Maira Santos Grizende  16 , Giovanna Grunewald Vietta  17 , Giulia Maria Dos Santos Goedert  18 , Guilherme Fagundes Nascimento  19 , Heloisa Reniers Vianna  20 , Isabela Muzzi Vasconcelos  21   22 , Joice Coutinho de Alvarenga  10 , José Miguel Chatkin  23   24 , Juliana Machado Rugolo  11 , Karen Brasil Ruschel  25   26   27 , Liege Barella Zandoná  28 , Luanna Silva Monteiro Menezes  29 , Luís César de Castro  28 , Maíra Dias Souza  29 , Marcelo Carneiro  30 , Maria Aparecida Camargos Bicalho  10   31 , Maria Izabel Alcântara Cunha  32 , Manuela Furtado Sacioto  8 , Neimy Ramos de Oliveira  33 , Pedro Guido Soares Andrade  22 , Raquel Lutkmeier  13 , Rochele Mosmann Menezes  30 , Antonio Luiz Pinho Ribeiro  34   35   36 , Milena Soriano Marcolino  21   22   25
Affiliations

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 et al. Front Med (Lausanne). .

Abstract

Background: Predicting 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.

Methods: Retrospective 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.

Results: Overall, 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).

Conclusion: The 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.

Keywords: COVID-19; intensive care unit; invasive mechanical ventilation; prognosis; risk assessment.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of the study conducted in two stages: (A) The first stage, aimed to assess the ABC2-SPH risk score to predict invasive mechanical ventilation in COVID-19 patients and compare with other available scores; and (B) the second stage, aimed to perform ABC2-SPH score recalibration, as well as to compare with other scores.
Figure 2
Figure 2
(A) Area under the receiving operator characteristic curves (AUROC) of ABC2-SPH and other scores in this cohort. The main information for each score is shown in Supplementary Table S1. (B) Calibration of ABC2-SPH score.
Figure 3
Figure 3
Calibration plot of the score recalibration.
See this image and copyright information in PMC

References

    1. Chang R, Elhusseiny KM, Yeh YC, Sun WZ. COVID-19 ICU and mechanical ventilation patient characteristics and outcomes-a systematic review and meta-analysis. PLoS One. (2021) 16:e0246318. doi: 10.1371/journal.pone.0246318, PMID: - DOI - PMC - PubMed
    1. DeCuir J, Surie D, Zhu Y, Gaglani M, Ginde AA, Douin DJ, et al. Effectiveness of monovalent mRNA COVID-19 vaccination in preventing COVID-19–associated invasive mechanical ventilation and death among immunocompetent adults during the omicron variant period — IVY network, 19 U.S. states, February 1, 2022–January 31, 2023. MMWR Morb Mortal Wkly Rep. (2023) 72:463–8. doi: 10.15585/mmwr.mm7217a3 - DOI - PubMed
    1. Tenforde MW, Self WH, Gaglani M, Ginde AA, Douin DJ, Talbot HK, et al. Effectiveness of mRNA vaccination in preventing COVID-19-associated invasive mechanical ventilation and death-United States, March 2021–January 2022. MMWR Morb Mortal Wkly Rep. (2022) 71:459–65. doi: 10.15585/mmwr.mm7112e1 - DOI - PMC - PubMed
    1. Leazer S, Collen J, Alcover K, Tompkins E, Ambardar S, Allard RJ, et al. Outcomes associated with intensive care and organ support among patients with COVID-19: a systematic review and Meta-analysis. Mil Med. (2023) 188:541–6. doi: 10.1093/milmed/usac143, PMID: - DOI - PMC - PubMed
    1. Marcolino MS, Pires MC, Ramos LEF, Silva RT, Oliveira LM, Carvalho RLR, et al. ABC2-SPH risk score for in-hospital mortality in COVID-19 patients: development, external validation and comparison with other available scores. Int J Infect Dis. (2021) 110:281–308. doi: 10.1016/j.ijid.2021.07.049, PMID: - DOI - PMC - PubMed

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