Intern Med . A Convenient Risk Prediction Score for COVID-19 for Determining Whether or Not Hospitalization is Recommended: Kanagawa Admission Priority Assessment Score

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Intern Med


. 2022 May 14.
doi: 10.2169/internalmedicine.9262-21. Online ahead of print.
A Convenient Risk Prediction Score for COVID-19 for Determining Whether or Not Hospitalization is Recommended: Kanagawa Admission Priority Assessment Score


Nobumasa Tamura ^{1 2} , Shota Uchiyama ^{1 2} , Saiko Nishioka ^{1 2} , Kentaro Tamura ^{1 2} , Masahiro Yoshida ¹ , Zenya Saito ^{1 2} , Kazuyoshi Kuwano ²



Affiliations

• PMID: 35569980
• DOI: 10.2169/internalmedicine.9262-21

Abstract

Objective Coronavirus disease 2019 (COVID-19) has caused a collapse of the medical care system, with effective triage proving vital. The Kanagawa admission priority assessment score, version-1 (KAPAS-1) and version-2 (KAPAS-2), was developed to determine the need for hospitalization. Patients with a high KAPAS (≥ 5) are recommended for hospitalization. We retrospectively investigated the correlation between the KAPAS and oxygen requirement during hospitalization. Methods We collected the clinical data of COVID-19 patients admitted between February 5 and December 6, 2020. Patients were divided into two groups: those who required oxygen therapy during hospitalization (OXY) and those who did not (NOXY). We assessed the correlations between the groups and KAPAS-1 and KAPAS-2. Results Overall, 117 COVID-19 patients were analyzed, including 20 OXY and 97 NOXY and 54 high KAPAS-1 and 63 high KAPAS-2. The median KAPAS-1 and KAPAS-2 were significantly higher in OXY than in NOXY (6.5 vs. 3, and 9 vs. 4, respectively). The areas under the receiver operating characteristic curves of KAPAS-1 and KAPAS-2 for oxygen requirement were 0.777 and 0.825, respectively, and the maximum values of Youden's index were 4 and 6, respectively. The proportions of high KAPAS-1 and high KAPAS-2 were significantly higher in OXY than in NOXY (90.0% vs. 37.1%, and 90.0% vs. 46.4%, respectively). Conclusion The KAPAS was significantly correlated with oxygen requirement. Furthermore, the KAPAS may be useful for deciding which patients are most likely to require hospitalization and for selecting non-hospitalized patients who should be carefully monitored.

Keywords: COVID-19; predictive score; severity; worsening.