Early fibroproliferative signs on high-resolution CT are associated with mortality in COVID-19 pneumonia patients with ARDS: a retrospective study.
Early fibroproliferative signs on high-resolution CT are associated with mortality in COVID-19 pneumonia patients with ARDS: a retrospective study.
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高分辨率 CT 上的早期纤维增殖体征与患有 ARDS 的 COVID-19 肺炎患者的死亡率相关：一项回顾性研究
DOI：
10.1177/2040622320982171
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发表时间：
2021
影响因子：
3.5
通讯作者：
Hu Q
中科院分区：
文献类型：
--
作者：
Zeng Z;Xiang M;Guan H;Liu Y;Zhang H;Xia L;Zhan J;Hu Q
目的：探讨新冠肺炎肺炎合并急性呼吸窘迫综合征患者的胸部高分辨率CT表现及其与临床转归的关系。材料和方法：选择79例新冠肺炎急性呼吸窘迫综合征患者为研究对象。从电子病历中提取临床数据并进行分析。由3名独立的观察者在临床急性呼吸窘迫综合征发病前3天内进行高分辨率CT扫描，并根据纤维增生的程度将其分为6种表现。多变量COX比例风险回归分析用于评估CT评分和放射学纤维增生的独立预测价值。患者生存由Kaplan-Meier分析决定。结果：与存活者相比，死亡者肺纤维增殖率较高，而无牵引性细支气管扩张或支气管性扩张者肺纤维密度增加的面积无显著差异。HRCT230分预测生存率的敏感度为73.5%，特异度为93.3%，阴性预测值为100%，阳性预测值为83.3%，准确度为88.6%( = 曲线下面积0.9；95%可信区间[CI]0.831-0.968)。多变量COX比例风险模型显示，HRCT评分是死亡率的显著独立危险因素(危险比[HR]9.94；95%可信区间4.10-24.12)。卡普兰-迈耶分析显示，HRCT评分⩾230与较高的病死率相关。与⩾评分为230的患者相比，HRCT评分为230的患者发生器官损伤的频率较低。结论：新冠肺炎肺炎合并早期急性呼吸窘迫综合征患者的早期肺纤维化征象与病死率和器官损害易感性增加有关。
Objectives: To investigate the chest high-resolution computed tomography (HRCT) findings in coronavirus disease 2019 (COVID-19) pneumonia patients with acute respiratory distress syndrome (ARDS) and to evaluate its relationship with clinical outcome. Materials and methods: In this retrospective study, 79 COVID-19 patients with ARDS were recruited. Clinical data were extracted from electronic medical records and analyzed. HRCT scans, obtained within 3 days before clinical ARDS onset, were evaluated by three independent observers and graded into six findings according to the extent of fibroproliferation. Multivariable Cox proportional hazard regression analysis was used to assess the independent predictive value of the computed tomography (CT) score and radiological fibroproliferation. Patient survival was determined by Kaplan–Meier analysis. Results: Compared with survivors, non-survivors showed higher rates of lung fibroproliferation, whereas there were no significant differences in the area of increased attenuation without traction bronchiolectasis or bronchiectasis. A HRCT score <230 enabled the prediction of survival with 73.5% sensitivity and 93.3% specificity, 100% negative predictive value (NPP), 83.3% positive predictive value (PPV) and 88.6% accuracy (Area Under the Curve [AUC] = 0.9; 95% confidence Interval [CI] 0.831–0.968). A multivariate Cox proportional hazards model showed that the HRCT score is a significant independent risk factor for mortality (Hazard Ratio [HR] 9.94; 95% CI 4.10–24.12). Kaplan–Meier analysis revealed that a HRCT score ⩾230 was associated with a higher fatality rate. Organ injury occurred less frequently in patients with a HRCT score <230 compared to those with a HRCT score ⩾230. Conclusion: Early pulmonary fibroproliferative signs on HRCT are associated with increased mortality and susceptibility to organ injury in COVID-19 pneumonia patients with early ARDS.
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DOI：
10.15557/pimr.2020.0003
发表时间：
2020-01-01
影响因子：
3.6
作者：
通讯作者：
--
影响因子：
2.9
作者：
Ichikado K;Muranaka H;Gushima Y;Kotani T;Nader HM;Fujimoto K;Johkoh T;Iwamoto N;Kawamura K;Nagano J;Fukuda K;Hirata N;Yoshinaga T;Ichiyasu H;Tsumura S;Kohrogi H;Kawaguchi A;Yoshioka M;Sakuma T;Suga M
通讯作者：
Suga M
DOI：
10.1164/rccm.2106157
发表时间：
2002-06-01
影响因子：
24.7
作者：
Ichikado, K;Suga, M;Ando, M
通讯作者：
Ando, M
影响因子：
38.9
作者：
Forel, Jean-Marie;Guervilly, Christophe;Papazian, Laurent
通讯作者：
Papazian, Laurent
影响因子：
38.9
作者：
Pelosi, Paolo;Rocco, Patricia R.
通讯作者：
Rocco, Patricia R.