Publicación: DEVELOPMENT AND VALIDATION OF THE PATIENT HISTORY COVID-19 (PH-COVID19) SCORING SYSTEM: A MULTIVARIABLE PREDICTION MODEL OF DEATH IN MEXICAN PATIENTS WITH COVID-19
Fecha
2020
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EPIDEMIOLOGY AND INFECTION
Resumen
MOST OF THE EXISTING PREDICTION MODELS FOR COVID-19 LACK VALIDATION, ARE INADEQUATELY REPORTED OR ARE AT HIGH RISK OF BIAS, A REASON WHICH HAS LED TO DISCOURAGE THEIR USE. FEW EXISTING MODELS HAVE THE POTENTIAL TO BE EXTENSIVELY USED BY HEALTHCARE PROVIDERS IN LOW-RESOURCE SETTINGS SINCE MANY REQUIRE LABORATORY AND IMAGING PREDICTORS. THEREFORE, WE SOUGHT TO DEVELOP AND VALIDATE A MULTIVARIABLE PREDICTION MODEL OF DEATH IN MEXICAN PATIENTS WITH COVID-19, BY USING DEMOGRAPHIC AND PATIENT HISTORY PREDICTORS. WE CONDUCTED A NATIONAL RETROSPECTIVE COHORT STUDY IN TWO DIFFERENT SETS OF PATIENTS FROM THE MEXICAN COVID-19 EPIDEMIOLOGIC SURVEILLANCE STUDY. PATIENTS WITH A POSITIVE REVERSE TRANSCRIPTION-POLYMERASE CHAIN REACTION FOR SARS-COV-2 AND COMPLETE UNDUPLICATED DATA WERE ELIGIBLE. IN TOTAL, 83 779 PATIENTS WERE INCLUDED TO DEVELOP THE SCORING SYSTEM THROUGH A MULTIVARIABLE COX REGRESSION MODEL; 100 000, TO VALIDATE THE MODEL. EIGHT PREDICTORS (AGE, SEX, DIABETES, CHRONIC OBSTRUCTIVE PULMONARY DISEASE, IMMUNOSUPPRESSION, HYPERTENSION, OBESITY AND CHRONIC KIDNEY DISEASE) WERE INCLUDED IN THE SCORING SYSTEM CALLED PH-COVID19 (RANGE OF VALUES: -2 TO 25 POINTS). THE PREDICTIVE MODEL HAS A DISCRIMINATION OF DEATH OF 0.8 (95% CONFIDENCE INTERVAL (CI) 0.796-0.804). THE PH-COVID19 SCORING SYSTEM WAS DEVELOPED AND VALIDATED IN MEXICAN PATIENTS TO AID CLINICIANS TO STRATIFY PATIENTS WITH COVID-19 AT RISK OF FATAL OUTCOMES, ALLOWING FOR BETTER AND EFFICIENT USE OF RESOURCES.
