Estimates in-hospital mortality in patients admitted for COVID-19.
When to use?
At admission in the emergency department, to stratify the in-hospital mortality risk of patients with COVID-19.
How was it developed and validated?
Based in a cohort of 5,032 patients from 36 hospitals, from 17 cities in Brazil, as well as a cohort of 474 Spanish patients, following strict methodological criteria. $^{1,2}$
Why to use?
How it should be used?
Only inhospital patients, through the use of variables easily accessible at admission.
How it should not be used?
Variable | ABC$_2$-SPH Score | |
---|---|---|
$A$ | $A$ge ($years$) | |
$\lt$ 60 | 0 | |
60 - 69 | 1 | |
70 - 79 | 3 | |
$\geqslant$ 80 | 5 | |
$B$ | $B$lood urea nitrogen ($mg/dL$)* | |
$\lt$ 42 | 0 | |
$\geqslant$ 42 | 3 | |
Or urea ($mg/dL$)* | ||
$\lt$ 90 | 0 | |
$\geqslant$ 90 | 3 | |
$C_2$ | $C$omorbidities (hypertension, diabetes mellitus, obesity, coronary artery disease, heart failure, atrial fibrillation or flutter, cirrhosis, cancer, COPD and previous stroke) | |
0 - 1 | 0 | |
$\geqslant$ 2 | 1 | |
$C$ reactive protein ($mg/L$) | ||
$\lt$ 100 | 0 | |
$\geqslant$ 100 | 1 | |
$S$ | $S$pO$_2$/FiO$_2$ (%) | |
$\gt$ 315 | 0 | |
235.1 - 315.0 | 1 | |
150.1 - 235 | 3 | |
$\leqslant$ 150 | 6 | |
$P$ | $P$latelet count ($x10^9/L$) | |
$\gt$ 150 | 0 | |
100 - 150 | 1 | |
$\lt$ 100 | 2 | |
$H$ | $H$earth rate ($bpm$) | |
$\leqslant$ 90 | 0 | |
91 - 30 | 1 | |
$\geqslant$ 131 | 2 |
Milena Soriano Marcolino$^1$, Magda Carvalho Pires$^2$, Rafael Tavares Silva$^3$, Lucas Emanuel Ferreira Ramos$^3$, Luana Martins Oliveira$^4$, Daniel Taiar Marinho Oliveira Ferrara$^5$, Maira Viana Rego Souza e Silva$^6$, Rafael Lima Rodrigues de Carvalho$^6$, Luanna da Silva Monteiro$^7$,Thaís Lorenna Souza Sales$^8$, Karina Paula Medeiros Prado Martins$^6$, Israel Júnior Borges do Nascimento$^6$, Talita Fischer Oliveira$^9$, Carisi Anne Polanczyk$^{10}$, Adrián Sánchez-Montalvá$^{11}$, Adriana Falangola Benjamin Bezerra$^{12}$, Alexandre Vargas Schwarbold$^{13}$, Aline Gabrielle Souza Nunes$^{14}$, Amanda de Oliveira Maurílio$^{15}$, Ana Lara Rodrigues Monteiro de Barros$^{16}$, Ana Luiza Bahia Alves Scotton$^{17}$, Ana Paula Beck da Silva Etges$^{10}$, Ana Paula Coutinho$^{18}$, Anderson Lacerda dos Reis$^{19}$, André Pinheiro Weber$^{20}$, André Soares de Moura Costa$^{21}$, Andresa Fontoura Garbini$^{22}$, Andressa Barreto Glaeser$^{23}$, Anelise Ferreira Fontana$^{22}$, Angélica Aparecida Coelho Madureira$^{16}$, Angelinda Rezende Bhering$^{14}$, Argenil José Assis de Oliveira$^{24}$, Bárbara Lopes Farace$^{24}$, Berta Raventós$^{25}$, Bruna Thais Schaefer$^{23}$, Bruno Mateus de Castro$^{18}$, Camila Felix Fortis$^{18}$, Carla Thais Cândida Alves da Silva$^{26}$, Carolina Marques Ramos$^{27}$, Caroline Danubia Gomes$^{19}$, Cássia Regina Gotler Medeiros$^{20}$, Christiane Corrêa Rodrigues Cimini$^{28}$, Cíntia Alcantara de Carvalho$^{29}$, Claudete Rempel$^{20}$, Claudiamara Borsatto$^{30}$, Daniel Vitório Silveira$^{14}$, Daniela Antunes de Lima$^{31}$, Daniela Ponce$^{32}$, Diego Henrique de Vasconcelos$^{33}$, Edilson Cezar$^{34}$, Elayne Crestani Pereira$^{35}$, Eliane Würdig Roesch$^{18}$, Emanuel Victor Alves Costa$^{36}$, Emanuele Marianne Souza Kroger$^{27}$, Euler Roberto Fernandes Manenti$^{19}$, Felipe Barbosa Vallt$^{26}$, Fernanda Barbosa Lucas$^{26}$, Fernanda d’Athayde Rodrigues$^{18}$, Fernanda Doumith Madureira$^{37}$, Fernando Anschau$^{22}$, Fernando Antonio Botoni$^{27}$, Fernando Graça Aranha$^{35}$, Filipe Carrilho de Aguiar$^{12}$, Francine Bernardo Vieira Pedroso$^{34}$, Frederico Bartolazzi$^{26}$, Gabriela Petry Crestani$^{19}$, Giovanna Grunewald Vietta$^{35}$, Gisele Alsina Nader Bastos$^{23}$, Glícia Cristina de Castro Madeira$^{16}$, Guilherme Fagundes Nascimento$^{14}$, Helena Carolina Noal$^{13}$, Helena Duani$^{33}$, Hellen Katya Wiebbelling$^{30}$, Heloisa Reniers Vianna$^{38}$, Henrique Cerqueira Guimarães$^{24}$, Isabela Moraes Gomes$^{16}$, Israel Molina$^{39}$, Izabel Cristina Sad das Chagas$^{37}$, Jamille Hemétrio Salles Martins Costa$^{31}$, Jéssica Rayane Corrêa Silva da Fonseca$^{40}$, Jessica Restello$^{30}$, Joanna d’Arc Lyra Batista$^{30}$, Joice Coutinho de Alvarenga$^{29}$, José Miguel Chatkin$^{41}$, Júlia Di Sabatino Santos Guimarães$^{27}$, Júlia Drumond Parreiras de Morais$^{38}$, Juliana da Silva Nogueira$^{12}$, Juliana Machado Rugolo$^{32}$, Juliana Tereza Coneglian de Almeida$^{32}$, Kaique Amancio Alvim Gouvea$^{40}$, Karen Brazil Ruschel$^{34}$, Karen Cristina Jung Rech Pontes$^{30}$, Kauane Aline Maciel dos Santos$^{18}$, Lara de Barros Wanderley Gomes$^{40}$, Lara Monalyza Gonçalves Franco$^{42}$, Leila Beltrami Moreira$^{18}$, Leonardo Hansen$^{30}$, Leonardo Seixas de Oliveira$^28$, Lílian Santos Pinheiro$^28$, Liliane Souto Pacheco$^{13}$, Luana Fonseca de Almeida$^{24}$, Lucas de Deus Sousa$^{17}$, Luciana Siuves Ferreira Couto$^{21}$, Luciane Kopittke$^{22}$, Luciano de Souza Viana$^{31}$, Luís César de Castro$^{20}$, Luis Cesar Souto de Moura$^{43}$, Luís Eduardo Stefani Brusamarello$^{41}$, Luis Joeci Jacques de Macedo Junior$^{22}$, Luisa Argolo Assis$^{27}$, Luisa Elem Almeida Santos$^{17}$, Luiz Antonio Nasi$^{23}$, Máderson Alvares de Souza Cabral$^{33}$, Magda Cesar Raposo$^{24}$, Maiara Anschau Floriani$^{23}$, Maíra Dias Souza$^{9}$, Majlla Magalhães Silva$^{31}$, Marcela Gonçalves Trindade Tofani$^{40}$, Marcelo Carneiro$^{44}$, Marconi Franco da Silveira$^{31}$, Marcus Vinicius Melo de Andrade$^{33}$, Maria Angélica Pires Ferreira$^{18}$, Maria Aparecida Camargos Bicalho$^{45}$, Maria Auxiliadora Parreiras Martins$^{21}$, Maria Clara Pontello Barbosa Lima$^{21}$, Mariana Balbinot Borges$^{34}$ Mariana de Braga Lima Carvalho Canesso$^{45}$, Mariana Frizzo de Godoy$^{41}$, Marilia Mastrocolla de Almeida Cardoso$^{32}$, Matheus Carvalho Alves Nogueira$^{21}$, Matheus Fernandes Lopes Martins$^{31}$, Meire Pereira de Figueiredo$^{26}$, Milton Henriques Guimarães Júnior$^{31}$, Mônica Aparecida de Paula de Sordi$^{32}$, Mychelle Stefany Santos Almeida$^{8}$, Natália da Cunha Severino Sampaio$^{36}$, Natália Lima Rangel$^{31}$, Natália Trifiletti Crespo$^{31}$, Neimy Ramos de Oliveira$^{36}$, Nicole de Moraes Pertile$^{23}$, Patricia Klarmann Ziegelmann$^{46}$, Pedro Guido Soares Andrade$^{40}$, Pedro Ledic Assaf$^{16}$, Petrônio José de Lima Martelli$^{12}$, Rafael Armando Seewald$^{20}$, Rafaela dos Santos Charão de Almeida$^{22}$, Rangner José Almeida Valença Mota$^{12}$, Raphael Castro Martins$^{43}$, Raquel Lutkmeier$^{22}$, Raulério Goulart Papini$^{30}$, Reginaldo Aparecido Valacio$^9$, Renan Goulart Finger$^{30}$, Ricardo Bertoglio Cardoso$^{10}$, Ricardo Braga Coelho$^{14}$, Roberta Pozza$^{43}$, Roberta Xavier Campos$^{27}$, Rochele Mosmann Menezes$^{44}$, Rodolfo Lucas Silva Mourato$^{15}$, Rodrigo Costa Pereira Vieira$^{42}$, Roger Mendes de Abreu$^{16}$, Rufino de Freitas Silva$^{15}$, Saionara Cristina Francisco$^{16}$, Silvana Mangeon Mereilles Guimarães$^{40}$, Silvia Ferreira Araújo$^{40}$, Sofia Jarjour Tavares Starling Lopes$^{27}$, Susany Anastácia Pereira$^{16}$, Taíse Maria Clemente de Araújo$^{12}$, Talita Regina Fiorio$^{43}$, Tatiana de Vargas$^{34}$, Tatiana Kurtz$^{44}$, Tatiani Oliveira Fereguetti$^{36}$, Thainara Conceição de Oliveira$^{34}$, Thaíza Simônia Marinho Albino de Araújo$^{16}$, Thalita Martins Lage$^{31}$, Thulio Henrique Oliveira Diniz$^{15}$, Umbelina Cravo Teixeira Lagioia$^{12}$, Veridiana Baldon dos Santos$^{22}$, Victor Eliel Bastos de Carvalho$^{27}$, Vinícius Andrade Almeida$^{12}$, Virginia Mara Reis Gomes$^{36}$, Vitor Augusto Lima do Vale$^{24}$, William Rutzen$^{44}$, Yuri Carlotto Ramires$^{20}$, Zilma Silveira Nogueira Reis$^{8}$
$^1$Principal investigator. Medical School, Telehealth Center and University Hospital, Universidade Federal de Minas Gerais; Instituto de Avaliação de Tecnologia em Saúde (IATS), Belo Horizonte, Brazil
$^2$Statistical coordinator. Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
$^3$Statistical team. Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
$^4$Field coordinator. Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
$^5$UX designer. Universidade FUMEC, Belo Horizonte, Brazil
$^6$Medical School, University Hospital, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
$^7$Hospital Metropolitano Odilon Behrens, Hospital Luxemburgo, Medical School, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
$^8$Universidade Federal de São João del-Rei, São João del-Rei, Brazil
$^9$Hospital Metropolitano Odilon Behrens, Belo Horizonte, Brazil
$^{10}$Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
$^{11}$Vall d’Hebron University Hospital, Vall d’Hebron Institute of Research (VHIR), Barcelona, Spain
$^{12}$University Hospital, Universidade Federal de Pernambuco, Recife, Brazil
$^{13}$Hospital Universitário de Santa Maria, Santa Maria, Brazil
$^{14}$Hospital UNIMED, Belo Horizonte, Brazil
$^{15}$Hospital São João de Deus, Divinópolis, Brazil
$^{16}$Hospital Metropolitano Doutor Célio de Castro, Belo Horizonte, Brazil
$^{17}$Hospital Regional Antônio Dias, Patos de Minas, Brazil
$^{18}$Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
$^{19}$Hospital Mãe de Deus, Porto Alegre, Brazil
$^{20}$Hospital Bruno Born, Lajeado, Brazil
$^{21}$Hospitais da Rede Mater Dei, Belo Horizonte, Brazil
$^{22}$Hospital Nossa Senhora da Conceição, Hospital Cristo Redentor, Porto Alegre, Brazil
$^{23}$Hospital Moinhos de Vento, Porto Alegre, Brazil
$^{24}$Hospital Risoleta Tolentino Neves, Belo Horizonte, Brazil
$^{25}$Infectious Diseases Department, Vall d’Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
$^{26}$Hospital de Santo Antônio, Curvelo, Brazil
$^{27}$Hospital Julia Kubitschek, Belo Horizonte, Brazil
$^{28}$Hospital Santa Rosália, Teófilo Otoni, Brazil
$^{29}$Hospital João XXIII, Belo Horizonte, Brazil
$^{30}$Hospital Regional do Oeste, Chapecó, Brazil
$^{31}$Hospital Márcio Cunha, Ipatinga, Brazil
$^{32}$University Hospital, Faculdade de Medicina de Botucatu, Botucatu, Brazil
$^{33}$University Hospital, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
$^{34}$Hospital Universitário Canoas, Canoas, Brazil
$^{35}$Hospital SOS Cárdio, Florianópolis, Brazil
$^{36}$Hospital Eduardo de Menezes, Belo Horizonte, Brazil
$^{37}$Hospital Regional de Barbacena Dr. José Américo, Barbacena, Brazil
$^{38}$Hospital Universitário Ciências Médicas, Belo Horizonte, Brazil
$^{39}$Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Brazil
$^{40}$Hospital Semper, Belo Horizonte, Brazil
$^{41}$Hospital São Lucas da PUCRS, Porto Alegre, Brazil
$^{42}$Hospital Luxemburgo, Instituto Mario Pena, Belo Horizonte, Brazil
$^{43}$Hospital Tacchini, Bento Gonçalves, Brazil
$^{44}$Hospital Santa Cruz, Santa Cruz do Sul, Brazil
$^{45}$Fundação Hospitalar do Estado de Minas Gerais (FHEMIG), Belo Horizonte, Brazil
$^{46}$Hospital Tacchini, Instituto de Avaliação de Tecnologia em Saúde (IATS), Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil