Evaluación de escalas de riesgo de neumonía por COVID-19 en el servicio de urgencias

  1. Alonso Valle, Héctor 1
  2. Peraita Fernández, Enrique 1
  3. Miró, Oscar 2
  4. Ortega, Mar 2
  5. Jiménez, Sonia 2
  6. Fresco, Leticia 2
  7. López Grima, Mª Luisa 3
  8. Juan Gómez, M.ª Ángeles 3
  9. Espinosa, Begoña 4
  10. Salido Mota, Manuel 5
  11. Bolanos Guedes, Julio 6
  12. Martín Mojarro, Enrique 7
  13. Tost, Josep 8
  14. López Díez, María Pilar 9
  15. Sorando Serra, Rosa 10
  16. Cano Cano, M.ª José 10
  17. Ferreras, José María 11
  18. Arribas Entrala, Belén 11
  19. Moyano García, Rocío 12
  20. Bedar Chaib, Fahd 13
  21. Llauger García, Lluis 14
  22. López-Laguna, Nieves 15
  23. Podaru, Mihai 15
  24. Pereira Sanz, Salvador 15
  25. Hernández Castells, Lourdes 15
  26. Lainez Martínez, Sara 16
  27. González del Castillo, Juan 16
  28. Show all authors +
  1. 1 Servicio de Urgencias, Hospital Universitario Marqués de Valdecilla, Santander, España.
  2. 2 Servicio de Urgencias, Hospital Clínic, Barcelona, España.
  3. 3 Servicio de Urgencias, Hospital Dr. Peset, Valencia, España.
  4. 4 Servicio de Urgencias, Hospital Alicante, Alicante, España.
  5. 5 Servicio de Urgencias, Hospital Universitario de Málaga, España.
  6. 6 Servicio de Urgencias, Hospital del Mar, Barcelona, España.
  7. 7 Hospital Santa Tecla, Tarragona, España.
  8. 8 Hospital Terrassa, Terrassa, Barcelona, España.
  9. 9 Hospital de Burgos, España.
  10. 10 Hospital Arnau Villanova, Valencia, España.
  11. 11 Hospital clínico Universitario Zaragoza, España.
  12. 12 Hospital Valle de los Pedroches, Pozoblanco, Córdoba.
  13. 13 Hospital de Soria, España.
  14. 14 Hospital de Vic, Barcelona, España.
  15. 15 Clínica Universitaria Navarra, Madrid, España.
  16. 16 Hospital Clínco San Carlos, Madrid, España.
Show affiliations +
Journal:
Revista Española de Urgencias y Emergencias

ISSN: 2951-6552,  2951-6544

Year of publication: 2022

Volume: 1

Issue: 1

Pages: 33-38

Type: Article

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Abstract

OBJECTIVE. To evaluate 2 scales for COVID-19 pneumonia severity and compare them to scales used to assess severity in general and community-acquired pneumonia. METHODS. Retrospective study of patients diagnosed with pneumonia in the emergency department and who tested positive for COVID-19 between March 1 and April 30, 2020. In addition to recording age and sex, we calculated scores with the 2 specific tools (PREDICOVID and CLINIC) as well as the National Early Warning Score (NEWS), the Quick Sequential Organ Failure Assessment (qSOFA), the Pneumonia Severity Index (PSI), and the CURB 65 score (for confusion, blood urea nitrogen level, respiratory rate, and systolic blood pressure). Outcomes recorded were hospitalization, admission to an intensive care unit (ICU), in-hospital mortality, and 30-day mortality. The area under the receiver operating characteristic curve (AUC) was calculated to assess each score’s ability to predict mortality. RESULTS. We analyzed data for 3499 patients. The mean (SD) age of patients included was 67.9 (17) years; 2660 of the patients (76%) were hospitalized, and 839 (27%) were admitted to the ICU. There were 630 in-hospital deaths (18.4%). Patients with PREDICOVID scores in the first to third quintiles had significantly lower in-hospital mortality (10.8% vs 38.1% in higher quintiles, P < .001). Patients with CLINIC scores indicating low to intermediate risk also had significantly lower in-hospital mortality (12.8% vs 85.7%, P < .001). The AUC values and 95% CIs for the scales as predictors of mortality were as follows: PSI, 0.69 (0.41-0.96); PREDICOVID, 0.65 (0.30-0.99); CLINIC, 0.63 (0.25-1.00), CURB-65, 0.62 (0.26-0.96); NEWS, 0.58 (0.23-0.94); and qSOFA, 0.38 (0.36-0.73). CONCLUSIONS. All 6 scales were able to predict mortality. The PSI had the greatest predictive capacity

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