Nogueira Matheus Carvalho Alves, Nobre Vandack, Pires Magda Carvalho, Ramos Lucas Emanuel Ferreira, Ribeiro Yara Cristina Neves Marques Barbosa, Aguiar Rubia Laura Oliveira, Vigil Flavia Maria Borges, Gomes Virginia Mara Reis, Santos Camila de Oliveira, Miranda Davi Mesquita, Durães Pamela Andrea Alves, da Costa Josiane Moreira, Schwarzbold Alexandre Vargas, Gomes Angélica Gomides Dos Reis, Pessoa Bruno Porto, Matos Carolina Cunha, Cimini Christiane Corrêa Rodrigues, de Carvalho Cíntia Alcântara, Ponce Daniela, Manenti Euler Roberto Fernandes, Cenci Evelin Paola de Almeida, Anschau Fernando, Costa Flávia Carvalho Cardoso, Nascimento Francine Janaina Magalhães, Bartolazzi Frederico, Grizende Genna Maira Santos, Vianna Heloisa Reniers, Nepomuceno Jomar Cristeli, Ruschel Karen Brasil, Zandoná Liege Barella, de Castro Luís César, Souza Maíra Dias, Carneiro Marcelo, Bicalho Maria Aparecida Camargos, Vilaça Mariana do Nascimento, Bonardi Naiara Patrícia Fagundes, de Oliveira Neimy Ramos, Lutkmeier Raquel, Francisco Saionara Cristina, Araújo Silvia Ferreira, Delfino-Pereira Polianna, Marcolino Milena Soriano
Department of Internal Medicine, Medical School and University Hospital, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
Department of Statistics, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
Front Med (Lausanne). 2023 Apr 20;10:1130218. doi: 10.3389/fmed.2023.1130218. eCollection 2023.
To assess the ABC-SPH score in predicting COVID-19 in-hospital mortality, during intensive care unit (ICU) admission, and to compare its performance with other scores (SOFA, SAPS-3, NEWS2, 4C Mortality Score, SOARS, CURB-65, modified CHA2DS2-VASc, and a novel severity score).
Consecutive patients (≥ 18 years) with laboratory-confirmed COVID-19 admitted to ICUs of 25 hospitals, located in 17 Brazilian cities, from October 2020 to March 2022, were included. Overall performance of the scores was evaluated using the Brier score. ABC-SPH was used as the reference score, and comparisons between ABC-SPH and the other scores were performed by using the Bonferroni method of correction. The primary outcome was in-hospital mortality.
ABC-SPH had an area under the curve of 0.716 (95% CI 0.693-0.738), significantly higher than CURB-65, SOFA, NEWS2, SOARS, and modified CHA2DS2-VASc scores. There was no statistically significant difference between ABC-SPH and SAPS-3, 4C Mortality Score, and the novel severity score.
ABC-SPH was superior to other risk scores, but it still did not demonstrate an excellent predictive ability for mortality in critically ill COVID-19 patients. Our results indicate the need to develop a new score, for this subset of patients.
评估ABC-SPH评分在预测新冠病毒病（COVID-19）患者重症监护病房（ICU）住院期间院内死亡率方面的表现，并将其与其他评分（序贯器官衰竭评估（SOFA）、简化急性生理学评分第3版（SAPS-3）、国家早期预警评分第2版（NEWS2）、4C死亡评分、SOARS、社区获得性肺炎改良英国胸科学会（CURB-65）评分、改良的充血性心力衰竭、高血压、年龄≥75岁、糖尿病、卒中（CHA2DS2-VASc）评分以及一种新的严重程度评分）进行比较。
纳入2020年10月至2022年3月期间连续入住巴西17个城市25家医院ICU且实验室确诊为COVID-19的患者（年龄≥18岁）。使用Brier评分评估各评分的总体表现。以ABC-SPH评分为参考评分，采用Bonferroni校正法对ABC-SPH评分与其他评分进行比较。主要结局为院内死亡率。
ABC-SPH评分的曲线下面积为0.716（95%可信区间0.693 - 0.738），显著高于CURB-65、SOFA、NEWS2、SOARS和改良的CHA2DS2-VASc评分。ABC-SPH评分与SAPS-3、4C死亡评分和新的严重程度评分之间无统计学显著差异。
ABC-SPH评分优于其他风险评分，但对危重症COVID-19患者的死亡率仍未显示出卓越的预测能力。我们的结果表明，需要为这类患者开发一种新的评分。
