A risk score to predict admission to the intensive care unit in patients with Covid-19: the ABC-GOALS score

Salud Publica Mex. 2020 Oct 10. doi: 10.21149/11684. Online ahead of print.

Abstract

Objective: To develop a score to predict the need for intensive care unit (ICU) admission in Covid-19.

Materials and methods: We assessed patients admitted to a Covid-19 center in Mexico. Patients were segregated into a group that required ICU admission, and a group that never required ICU admission. By logistic regression, we derived predictive models including clinical, laboratory, and imaging findings. The ABC-GOALS was constructed and compared to other scores.

Results: We included 329 and 240 patients in the development and validation cohorts, respectively. Onehundred- fifteen patients from each cohort required ICU admission. The clinical (ABC-GOALSc), clinical+laboratory (ABC-GOALScl), clinical+laboratory+image (ABC-GOALSclx) models area under the curve were 0.79 (95%CI=0.74-0.83) and 0.77 (95%CI=0.71-0.83), 0.86 (95%CI=0.82-0.90) and 0.87 (95%CI=0.83-0.92), 0.88 (95%CI=0.84-0.92) and 0.86 (95%CI=0.81-0.90), in the development and validation cohorts, respectively. The ABC-GOALScl and ABC-GOALSclxoutperformed other Covid-19 and pneumonia predictive scores.

Conclusions: ABC-GOALS is a tool to timely predict the need for admission to ICU in Covid-19.

Objective: Desarrollar un puntaje predictivo de la necesidad de ingreso a una unidad de cuidados intensivos (UCI) en Covid-19.

Materials and methods: Se evaluaron pacientes ingresados por Covid-19 en México. Se dividieron en un grupo que requirió ingreso a UCI y un grupo que nunca lo requirió. Se derivaron modelos predictivos incluyendo variables clínicas, de laboratorio e imagen y se integraron en el puntaje ABC-GOALS.

Results: Se incluyeron 329 y 240 pacientes en cohortes de desarrollo y validación, respectivamente. Ciento quince pacientes de cada cohorte requirieron ingreso a UCI. Las áreas bajo la curva de los modelos clínico (ABC-GOALSc), clínico+laboratorio (ABCGOALS cl), clínico+laboratorio+imagen (ABC-GOALSclx) fueron 0.79 (IC95%=0.74-0.83) y 0.77 (IC95%=0.71-0.83); 0.86 (IC95%=0.82-0.90) y 0.87 (IC95%=0.83-0.92); 0.88 (IC95%=0.84-0.92) y 0.86 (IC95%=0.81-0.90) en las cohortes de derivación y validación, respectivamente. El desempeño del ABC-GOALS fue superior a otros puntajes de riesgo.

Conclusions: ABC-GOALS es una herramienta para predecir oportunamente la necesidad de ingreso a UCI en Covid-19.

Keywords: Covid-19; coronavirus; intensive care; pandemic; prediction.