Can Thoracic Ultrasound on Admission Predict the Outcome of Critically Ill Patients with SARS-CoV-2? A French Multi-Centric Ancillary Retrospective Study.
Can Thoracic Ultrasound on Admission Predict the Outcome of Critically Ill Patients with SARS-CoV-2? A French Multi-Centric Ancillary Retrospective Study.
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DOI：
10.1007/s12325-021-01702-0
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发表时间：
2021-05
影响因子：
3.8
通讯作者：
Zieleskiewicz L
中科院分区：
文献类型：
--
作者：
Duclos G;Bazalguette F;Allaouchiche B;Mohammedi N;Lopez A;Gazon M;Besch G;Bouvet L;Muller L;Mathon G;Arbelot C;Boucekine M;Leone M;Zieleskiewicz L
严重急性呼吸道综合征冠状病毒2（SARS-CoV-2）的爆发导致了重症监护病房（ICU）的大量入院。在这些患者中，在入院时广泛进行胸部超声检查。本研究的主要目的是评估肺部超声评分（LUS）在ICU入院时预测SARS-CoV-2患者28天死亡率的性能。次要目的是评估胸部超声的性能和心脏损伤的生物标志物，以预测死亡率。这项多中心、回顾性、观察性研究于2020年3月15日至5月3日在法国四所大学医院的六个ICU中进行。纳入了因SARS-CoV-2相关急性呼吸衰竭而入住ICU的患者和入院时接受LUS检查的患者。确定LUS评分的受试者工作特征（ROC）曲线下面积，以预测28天死亡率。对入院时的简化急性生理评分、左心室射血分数、心输出量、脑钠肽和超敏肌钙蛋白水平进行了相同的分析。在57例患者中，28天死亡率为21%。ICU入院时LUS评分值的ROC曲线下面积为0.68 [95% CI 0.54-0.82; p = 0.05]。在入住ICU的非插管患者中（n = 40），ROC曲线下面积为0.84 [95% CI 0.70-0.97; p = 0.005]。最佳临界值22对应于85%的特异性和83%的灵敏度。因SARS-CoV-2而入住ICU的LUS评分不能有效预测28天死亡率。入院时未插管患者的性能更好。生物心脏标志物的性能可能等同于LUS评分。在线版本包含补充材料，可通过10.1007/s12325-021-01702-0获得。
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreaks have led to massive admissions to intensive care units (ICUs). An ultrasound examination of the thorax is widely performed on admission in these patients. The primary objective of our study was to assess the performance of the lung ultrasound score (LUS) on ICU admission to predict the 28-day mortality rate in patients with SARS-CoV-2. The secondary objective was to asses the performance of thoracic ultrasound and biological markers of cardiac injury to predict mortality. This multicentre, retrospective, observational study was conducted in six ICUs of four university hospitals in France from 15 March to 3 May 2020. Patients admitted to ICUs because of SARS-CoV-2-related acute respiratory failure and those who received an LUS examination at admission were included. The area under the receiver-operating characteristics (ROC) curve was determined for the LUS score to predict the 28-day mortality rate. The same analysis was performed for the Simplified Acute Physiology Score, left ventricular ejection fraction, cardiac output, brain natriuretic peptide and ultra-sensitive troponin levels at admission. In 57 patients, the 28-day mortality rate was 21%. The area under the ROC curve of the LUS score value on ICU admission was 0.68 [95% CI 0.54–0.82; p = 0.05]. In non-intubated patients on ICU admission (n = 40), the area under the ROC curves was 0.84 [95% CI 0.70–0.97; p = 0.005]. The best cut-off of 22 corresponded to 85% specificity and 83% sensitivity. LUS scores on ICU admission for SARS-CoV-2 did not efficiently predict the 28-day mortality rate. Performance was better for non-intubated patients at admission. Performance of biological cardiac markers may be equivalent to the LUS score. The online version contains supplementary material available at 10.1007/s12325-021-01702-0.
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影响因子：
9.6
作者：
Lichtenstein, Daniel A.
通讯作者：
Lichtenstein, Daniel A.
影响因子：
2.9
作者：
Bonadia, Nicola;Carnicelli, Annamaria;Franceschi, Francesco
通讯作者：
Franceschi, Francesco
DOI：
10.1164/rccm.201003-0369oc
发表时间：
2011-02-01
影响因子：
24.7
作者：
Bouhemad, Belaid;Brisson, Helene;Rouby, Jean-Jacques
通讯作者：
Rouby, Jean-Jacques
DOI：
10.1186/cc10368
发表时间：
2011-08-16
期刊：
Critical care (London, England)
影响因子：
--
作者：
Bergenzaun L;Gudmundsson P;Öhlin H;Düring J;Ersson A;Ihrman L;Willenheimer R;Chew MS
通讯作者：
Chew MS
影响因子：
120.7
作者：
LEGALL, JR;LEMESHOW, S;SAULNIER, F
通讯作者：
SAULNIER, F