P-1981. MMCD score for predicting kidney replacement therapy in hospitalized patients with COVID-19 from 2020 to 2022

Abstract Background Acute kidney injury (AKI) requiring kidney replacement therapy (KRT) in its most severe forms is a significant complication of patients with COVID-19. The development of a risk score to predict KRT requirement could optimize health resource allocation. Thus, this study aimed to develop and validate a score to predict the KRT requirement in hospitalized patients with COVID-19 from 2020 to 2022. Area under the receiver operating characteristic curve for the 2021-2022 validation of MMCD score Methods This is a multicenter retrospective cohort of consecutive patients hospitalized for COVID-19, confirmed by laboratory tests, in 40 Brazilian hospitals, from March 2020 to July 2022. Patients under 18 years old, pregnant, in palliative care, or in dialysis therapy at admission were excluded from the study. Predictor variables were selected using generalized additive models (GAM) and the least absolute shrinkage and selection operator (LASSO) regression was used for score derivation. The score was developed in the period from March to July 2020, with temporal and geographic validation from July to September 2020 and new temporal validation from March 2021 to July 2022. The performance of the score was evaluated by the area under the receiver operating characteristic curve (AUROC, with a 95% confidence interval), graphical analysis with intercept and slope test, and Brier score. Calibration for the validation of MMCD score Results The study included 3,680 patients in the development sample, 1,532 in the 2020 temporal validation, 1,378 in the geographic validation, and 9,473 in the 2021-2022 temporal validation. Four predictors were identified: mechanical ventilation at any time during hospitalization, male sex, admission creatinine, and diabetes mellitus. The score named MMCD showed excellent performance in the derivation and validations cohorts (development AUROC 0.929, CI 0.918–0.939, Brier 0.057; 2020 temporal validation AUROC 0.927, CI 0.911–0.941, Brier 0.056; 2020 geographic validation AUROC 0.819, CI 0.792–0.845, Brier 0.122; 2021/2022 temporal validation AUROC 0.916, CI 0.909-0.924, Brier 0.057). Conclusion The MMCD showed excellent predictive ability for KRT in different phases of the pandemic, which can contribute to support more assertive decisions in the allocation of care resources, in addition to efficient clinical management. Disclosures All Authors: No reported disclosures

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Journal
Open Forum Infectious Diseases
Published
2025-01-29
DOI
https://doi.org/10.1093/ofid/ofae631.2139
Primary Topic
Sepsis Diagnosis and Treatment
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article
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article

P-1981. MMCD score for predicting kidney replacement therapy in hospitalized patients with COVID-19 from 2020 to 2022

Karen Brasil Ruschel, Angélica Gomides dos Reis Gomes, Marcelo Carneiro, Joanna d’Arc Lyra Batista et al.
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Open Forum Infectious Diseases
Sepsis Diagnosis and Treatment
article

P-1981. MMCD score for predicting kidney replacement therapy in hospitalized patients with COVID-19 from 2020 to 2022

Karen Brasil Ruschel, Angélica Gomides dos Reis Gomes, Marcelo Carneiro, Joanna d’Arc Lyra Batista, Magda Carvalho Pires, Frederico Bartolazzi, Kátia de Paula Farah, Alzira de Oliveira Jorge, Genna Maira Santos Grizende, Silvana Mangeon Mereilles Guimarães, Tatiani Oliveira Fereguetti, Fernando Graça Aranha, Vanessa das Graças José Ventura, Christiane Corrêa Rodrigues Cimini, Pedro Gibson Paraíso, Eneida Santos de Oliveira, Luanna Silva Monteiro Menezes, Fernando Anschau, Polianna Delfino-Pereira, Danyelle Romana Alves Rios, Flávio de Azevedo Figueiredo, Luiza Marinho Motta Santa Rosa, Alexandre Vargas Schwarzbold, Daniela Ponce, Milena Soriano Marcolino, Bruno Porto Pessoa, Saionara Cristina Francisco, Lucas Rocha Valle
article en

Abstract

Abstract Background Acute kidney injury (AKI) requiring kidney replacement therapy (KRT) in its most severe forms is a significant complication of patients with COVID-19. The development of a risk score to predict KRT requirement could optimize health resource allocation. Thus, this study aimed to develop and validate a score to predict the KRT requirement in hospitalized patients with COVID-19 from 2020 to 2022. Area under the receiver operating characteristic curve for the 2021-2022 validation of MMCD score Methods This is a multicenter retrospective cohort of consecutive patients hospitalized for COVID-19, confirmed by laboratory tests, in 40 Brazilian hospitals, from March 2020 to July 2022. Patients under 18 years old, pregnant, in palliative care, or in dialysis therapy at admission were excluded from the study. Predictor variables were selected using generalized additive models (GAM) and the least absolute shrinkage and selection operator (LASSO) regression was used for score derivation. The score was developed in the period from March to July 2020, with temporal and geographic validation from July to September 2020 and new temporal validation from March 2021 to July 2022. The performance of the score was evaluated by the area under the receiver operating characteristic curve (AUROC, with a 95% confidence interval), graphical analysis with intercept and slope test, and Brier score. Calibration for the validation of MMCD score Results The study included 3,680 patients in the development sample, 1,532 in the 2020 temporal validation, 1,378 in the geographic validation, and 9,473 in the 2021-2022 temporal validation. Four predictors were identified: mechanical ventilation at any time during hospitalization, male sex, admission creatinine, and diabetes mellitus. The score named MMCD showed excellent performance in the derivation and validations cohorts (development AUROC 0.929, CI 0.918–0.939, Brier 0.057; 2020 temporal validation AUROC 0.927, CI 0.911–0.941, Brier 0.056; 2020 geographic validation AUROC 0.819, CI 0.792–0.845, Brier 0.122; 2021/2022 temporal validation AUROC 0.916, CI 0.909-0.924, Brier 0.057). Conclusion The MMCD showed excellent predictive ability for KRT in different phases of the pandemic, which can contribute to support more assertive decisions in the allocation of care resources, in addition to efficient clinical management. Disclosures All Authors: No reported disclosures

Open Forum Infectious DiseasesVol. 12(Supplement_1)
Universidade Federal de Minas Gerais (BR), Hospital Universitário de Santa Maria (BR), Hospital Nossa Senhora da Conceição (BR), Universidade Federal dos Vales do Jequitinhonha e Mucuri (BR), Grupo Santa Casa de Belo Horizonte (BR), Hospital de Santo António (PT), Hospital Metropolitano (EC), Fundação de Amparo à Pesquisa e Inovação do Estado de Santa Catarina (BR), Fundação Hospitalar do Estado de Minas Gerais (BR), Mater Dei Hospital (BR), Universidade Estadual Paulista (Unesp) (BR)
Openalex Percentile: Top 98%
Sepsis Diagnosis and Treatment
DOIOpen Access PDFOpenAlex
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