期刊论文详细信息
Journal of the American Board of Family Medicine: JABFM
Development and Validation of Simple Risk Scores to Predict Hospitalization in Outpatients with COVID-19 Including the Omicron Variant
article
Mark H. Ebell1  Roya Hamadani2  Autumn Kieber-Emmons2 
[1] Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia;University of South Florida Morsani College of Medicine, Lehigh Valley Health Network
关键词: Clinical Decision-Making;    Clinical Prediction Rule;    COVID-19;    Family Medicine;    Infectious Diseases;    Mobile Applications;    Outpatients;    Pennsylvania;    Retrospective Studies;    SARS-CoV-2 Variants;   
DOI  :  10.3122/jabfm.2022.220056R1
学科分类:过敏症与临床免疫学
来源: The American Board of Family Medicine
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【 摘 要 】

Introduction: Outpatient physicians need guidance to support decisions regarding hospitalization of COVID-19 patients and how closely to follow outpatients. Thus, we sought to develop and validate simple risk scores to predict hospitalization for outpatients with COVID-19 that do not require laboratory testing or imaging.Methods: We identified outpatients 12 years and older who had a positive polymerase chain reaction test for SARS-CoV-2. Logistic regression was used to derive a risk score in patients presenting before March, 2021, and it was validated in a cohort presenting from March to September 2021 and an Omicron cohort from December, 2021 to January, 2022.Results: Overall, 4.0% of 5843 outpatients in the early derivation cohort (before 3/1/21), 4.2% of 3806 outpatients in the late validation cohort, and 1.2% in an Omicron cohort were hospitalized. The base risk score included age, dyspnea, and any comorbidity. Other scores added fever, respiratory rate and/or oxygen saturation. All had very good overall accuracy (AUC 0.85–0.87) and classified about half of patients into a low-risk group with < 1% hospitalization risk. Hospitalization rates in the Omicron cohort were 0.22%, 1.3% and 8.7% for the base score. Two externally derived risk scores identified more low risk patients, but with a higher overall risk of hospitalization than our novel risk scores.Conclusions: A simple risk score suitable for outpatient and telehealth settings can classify over half of COVID-19 outpatients into a very low risk group with a 0.22% hospitalization risk in the Omicron cohort. The Lehigh Outpatient COVID Hospitalization (LOCH) risk score is available online as a free app: https://ebell-projects.shinyapps.io/LehighRiskScore/.

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CC BY   

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