Reliability of predictive models to support early decision making in the emergency department for patients with confirmed diagnosis of COVID-19: the Pescara Covid Hospital score

Polilli, Ennio; Frattari, Antonella; Esposito, Jessica Elisabetta; D’Amato, Milena; Rapacchiale, Giorgia; D’Intino, Angela; Albani, Alberto; Di Iorio, Giancarlo; Carinci, Fabrizio; Parruti, Giustino

doi:10.1186/s12913-022-08421-4

Table 4 Algorithms for the calculation of scores

From: Reliability of predictive models to support early decision making in the emergency department for patients with confirmed diagnosis of COVID-19: the Pescara Covid Hospital score

	Hospitalisation				Oxygen Support < 70 yrs				Intensive Therapy < 70 yrs				Death
Algorithm Condition value: [1 = Yes; 0 = No]	round(0.02 * [age]) + + 1 * [Male] + 3 * [Diabetes] + 2 * [Dyspnea] + 3 * [Procalcitonin ≥0.2 ng/mL] + 4 * [MDW ≥ 22] + 3 * [Saturation ≤ 95%] + 2 * [D-dimer ≥0.72 mg/L] + 2 * [Prothrombin time < 95%] + 3 * [CRP ≥ 21 mg/L]				6 * [LDH ≥237 U/L] + 11 * [Saturation < 95%] + 4 * [Lymphocytes < 1.2 × 10³/μL]				round(0.05 * [Age]) + + 59 * [ESRD] + 6 * [LDH ≥ 334 U/L] + 3 * [MDW ≥ 25] + 5 * [D-dimer ≥2.37 mg/L] + 3 * [Lymphocytes < 0.7 × 10³/μL]				round(0.06* [Age]) + + 2* [ESRD]) + 3* [Procalcitonin ≥0.2 ng/mL]) + 2* [LDH ≥ 307 U/L]) + 3* [Saturation < 96%]) + 2* [D-dimer ≥1.04 mg/L])
Optimal Cutpoint	≥12				≥8				≥10				≥10
Study population (“Alpha”: May–June 2020)
Confusion Matrix		Yes	No			Yes	No			Yes	No			Yes	No
	Score +	284	19	303	Score +	111	10	121	Score +	42	35	77	Score +	118	80	192
	Score -	73	132	205	Score -	17	34	51	Score -	9	88	97	Score -	15	297	312
	Total	357	151	508	Total	128	44	172	Total	51	126	174	Total	133	377	510
Youden Index	0.67				0.64				0.54				0.67
Sensitivity	0.80 (0.75–0.83)				0.87 (0.80–0.91)				0.82 (0.70–0.90)				0.89 (0.82–0.93)
Specificity	0.87 (0.81–0.92)				0.77 (0.63–0.87)				0.71 (0.63–0.79)				0.79 (0.74–0.83)
PPV	0.94 (0.90–0.96)				0.92 (0.86–0.95)				0.54 (0.43–0.65)				0.60 (0.53–0.66)
NPV	0.64 (0.58–0.71)				0.67 (0.53–0.78)				0.91 (0.83–0.95)				0.95 (0.92–0.97)
LR+	6.32 (4.29–10.30)				3.82 (2.38–7.68)				2.89 (2.16–4.05)				4.18 (3.43–5.20)
LR-	0.23 (0.19–0.29)				0.17 (0.10–0.26)				0.25 (0.11–0.41)				0.14 (0.08–0.22)
Accuracy	0.82				0.84				0.75				0.81
AUC	0.91 (0.89–0.94)				0.87 (0.82–0.92)				0.81 (0.73–0.89)				0.91 (0.87–0.94)

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