Development and validation of the OUTCoV score to predict the risk of hospitalisation among patients with SARS-CoV-2 infection in ambulatory settings: a prospective cohort study

ObjectivesTo develop and validate a rule-out prediction model for the risk of hospitalisation among patients with SARS-CoV-2 infection in the ambulatory setting to derive a simple score to determine outpatient follow-up.DesignProspective cohort study.SettingSwiss university hospital.Participants1459...

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Bibliographic Details
Published in:BMJ open 2021-06, Vol.11 (6), p.e044242-e044242
Main Authors: Jacquerioz, Frederique, Baggio, Stéphanie, Gayet-Ageron, Angele, Chappuis, François, Getaz, Laurent, Guessous, Idris, Kaiser, Laurent, Vernaz, Nathalie, Yerly, Sabine, Salamun, Julien, Spechbach, Herve
Format: Article
Language:English
Subjects:
Abdomen
Age
Calibration
Cardiovascular disease
Cohort analysis
Coronaviruses
COVID-19
Diabetes
Emergency medical care
Epidemics
Fever
general medicine (see internal medicine)
Hypertension
Infections
Infectious Diseases
Laboratories
Optimism
Pneumonia
Public health
Questionnaires
Respiratory diseases
risk management
Severe acute respiratory syndrome coronavirus 2
Variables
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Summary:ObjectivesTo develop and validate a rule-out prediction model for the risk of hospitalisation among patients with SARS-CoV-2 infection in the ambulatory setting to derive a simple score to determine outpatient follow-up.DesignProspective cohort study.SettingSwiss university hospital.Participants1459 individuals with a positive result for SARS-CoV-2 infection between 2 March and 23 April 2020.MethodsWe applied the rule of 10 events per variable to construct our multivariable model and included a maximum of eight covariates. We assessed the model performance in terms of discrimination and calibration and performed internal validation to estimate the statistical optimism of the final model. The final prediction model included age, fever, dyspnoea, hypertension and chronic respiratory disease. To develop the OUTCoV score, we assigned points for each predictor that were proportional to the coefficients of the regression equation. Sensitivity, specificity, positive and negative likelihood ratios were estimated, including positive and negative predictive values in different thresholds.Main outcome measureThe primary outcome was COVID-19-related hospitalisation.ResultsThe OUTCoV score ranged from 0 to 7.5 points. The two threshold parameters with optimal rule-out and rule-in characteristics for the risk of hospitalisation were 3 and 5.5, respectively. Outpatients with a score
ISSN:2044-6055
2044-6055
DOI:10.1136/bmjopen-2020-044242