DERIVATION OF A SCORE TO PREDICT ADMISSION TO INTENSIVE CARE UNIT IN PATIENTS WITH COVID-19: THE ABC-GOALS SCORE

Mejia-Vilet, J. M.; Cordova-Sanchez, B. M.; Fernandez-Camargo, D.; Mendez-Perez, R. A.; Morales-Buenrostro, L. E.; Hernandez-Gilsoul, T.

Background. COVID-19 pandemic poses a burden on hospital resources and intensive care unit (ICU) occupation. The study aimed to derive a scoring system that, assessed upon patient first-contact evaluation, predicts the need for admission to ICU. Methods. All consecutive patients admitted to a COVID-19 reference center were prospectively assessed. Patients were segregated into a group that required admission to ICU during their hospitalization and a group that never required ICU admission and was already discharged from hospitalization. Three models including clinical, laboratory and imaging findings were derived by logistic regression analysis and internally validated. A score, defined as the ABC-GOALS score was created by assigning values based on the variables weighted odd ratios. Results. The study comprised 329 patients, 115 (35%) required ICU admission and 214 (65%) were hospitalized and discharged from general wards. The clinical prediction model (ABC-GOALSc) included sex, obesity, the Charlson comorbidity index, dyspnea, arterial pressure and respiratory rate at triage evaluation. The clinical plus laboratory model (ABC-GOALScl) added serum albumin, glucose, lactate dehydrogenase and S/F ratio to the clinical model. The model that included imaging (ABC-GOALSclx) added the CT scan finding of >50% lung involvement. All three models outperformed other pneumonia-specific scores with area under the curve of 0.79 (0.74-0.83), 0.86 (0.82-0.90) and 0.88 (0.84-0.92) for the clinical, laboratory and imaging model, respectively. Conclusion. The ABC-GOALS score is a tool to evaluate patients with COVID-19 at admission to the emergency department that allows to timely predict their risk of admission to an ICU and may help optimize healthcare capacities.