Your browser doesn't support javascript.
Development and Validation of a Clinical Risk Score to Predict Hospitalization Within 30 Days of Coronavirus Disease 2019 Diagnosis.
Aboumrad, Maya; Zwain, Gabrielle; Smith, Jeremy; Neupane, Nabin; Powell, Ethan; Dempsey, Brendan; Reyes, Carolina; Satram, Sacha; Young-Xu, Yinong.
  • Aboumrad M; Clinical Epidemiology Program, White River Junction Veterans Affairs Medical Center, White River Junction, VT 05009, USA.
  • Zwain G; Clinical Epidemiology Program, White River Junction Veterans Affairs Medical Center, White River Junction, VT 05009, USA.
  • Smith J; Clinical Epidemiology Program, White River Junction Veterans Affairs Medical Center, White River Junction, VT 05009, USA.
  • Neupane N; Clinical Epidemiology Program, White River Junction Veterans Affairs Medical Center, White River Junction, VT 05009, USA.
  • Powell E; Clinical Epidemiology Program, White River Junction Veterans Affairs Medical Center, White River Junction, VT 05009, USA.
  • Dempsey B; Clinical Epidemiology Program, White River Junction Veterans Affairs Medical Center, White River Junction, VT 05009, USA.
  • Reyes C; Division of Health Economics and Outcomes Research, VIR Biotechnology Inc., San Francisco, CA 94158, USA.
  • Satram S; Division of Health Economics and Outcomes Research, VIR Biotechnology Inc., San Francisco, CA 94158, USA.
  • Young-Xu Y; Clinical Epidemiology Program, White River Junction Veterans Affairs Medical Center, White River Junction, VT 05009, USA.
Mil Med ; 2021 Oct 06.
Article in English | MEDLINE | ID: covidwho-1455331
ABSTRACT

INTRODUCTION:

Early identification of patients with coronavirus disease 2019 (COVID-19) who are at risk for hospitalization may help to mitigate disease burden by allowing healthcare systems to conduct sufficient resource and logistical planning in the event of case surges. We sought to develop and validate a clinical risk score that uses readily accessible information at testing to predict individualized 30-day hospitalization risk following COVID-19 diagnosis.

METHODS:

We assembled a retrospective cohort of U.S. Veterans Health Administration patients (age ≥ 18 years) diagnosed with COVID-19 between March 1, 2020, and December 31, 2020. We screened patient characteristics using Least Absolute Shrinkage and Selection Operator logistic regression and constructed the risk score using characteristics identified as most predictive for hospitalization. Patients diagnosed before November 1, 2020, comprised the development cohort, while those diagnosed on or after November 1, 2020, comprised the validation cohort. We assessed risk score discrimination by calculating the area under the receiver operating characteristic (AUROC) curve and calibration using the Hosmer-Lemeshow (HL) goodness-of-fit test. This study was approved by the Veteran's Institutional Review Board of Northern New England at the White River Junction Veterans Affairs Medical Center (Reference no.1473972-1).

RESULTS:

The development and validation cohorts comprised 11,473 and 12,970 patients, of whom 4,465 (38.9%) and 3,669 (28.3%) were hospitalized, respectively. The independent predictors for hospitalization included in the risk score were increasing age, male sex, non-white race, Hispanic ethnicity, homelessness, nursing home/long-term care residence, unemployed or retired status, fever, fatigue, diarrhea, nausea, cough, diabetes, chronic kidney disease, hypertension, and chronic obstructive pulmonary disease. Model discrimination and calibration was good for the development (AUROC = 0.80; HL P-value = .05) and validation (AUROC = 0.80; HL P-value = .31) cohorts.

CONCLUSIONS:

The prediction tool developed in this study demonstrated that it could identify patients with COVID-19 who are at risk for hospitalization. This could potentially inform clinicians and policymakers of patients who may benefit most from early treatment interventions and help healthcare systems anticipate capacity surges.

Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Type of study: Diagnostic study / Etiology study / Patient-preference / Prognostic study / Risk factors Language: English Clinical aspect: Etiology / Prediction / Prognosis Year: 2021

Similar

MEDLINE

...
LILACS

LIS


Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Type of study: Diagnostic study / Etiology study / Patient-preference / Prognostic study / Risk factors Language: English Clinical aspect: Etiology / Prediction / Prognosis Year: 2021
...