• Francisco Martín-Rodríguez, Ancor Sanz-García, Ana Alberdi Iglesias, Guillermo Ortega Rabbione, Carlos Del Pozo Vegas, Isabel de la Torre-Díez, Germán Fernández Bayón, Juan Francisco Delgado Benito, Marta Gómez-Escolar Pérez, José Javier García Cortés, and Raúl López-Izquierdo.
• Gerencia de Emergencias Sanitarias, Gerencia Regional de Salud de Castilla y León (SACYL), España. Facultad de Medicina, Universidad de Valladolid, Valladolid, España.
• Emergencias. 2021 Aug 1; 33 (4): 265-272.

ObjectivesTo develop and validate a scale to stratify risk of 2-day mortality based on data collected during calls to an emergency dispatch center from patients with suspected coronavirus disease 2019 (COVID-19).Material And MethodsRetrospective multicenter study of consecutive patients over the age of 18 years with suspected COVID-19 who were transported from home over the course of 3 months after telephone interviews with dispatchers. We analyzed clinical and epidemiologic variables and comorbidities in relation to death within 2 days of the call. Using data from the development cohort, we built a risk model by means of logistic regression analysis of categorical variables that were independently associated with 2-day mortality. The scale was validated first in a validation cohort in the same province and then in a cohort in a different province.ResultsA total of 2320 patients were included. The mean age was 79 years, and 49.8% were women. The overall 2-day mortality rate was 22.6% (376 deaths of patients with severe acute respiratory syndrome coronavirus 2 infection). The model included the following factors: age, location (rural location as a protective factor), institutionalization, desaturation, lung sounds (rhonchi), and altered mental status. The area under the receiver operating characteristic curve for death within 2 days was 0.763 (95% CI, 0.725-0.802; P .001). Mortality in patients at high risk (more than 2.4 points on the scale) was 60%.ConclusionThis risk scale derived from information available to an emergency dispatch center is applicable to patients with suspected COVID-19. It can stratify patients by risk of early death (within 2 days), possibly helping with decision making regarding whether to transport from home or what means of transport to use, and destination.

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