Factors Predicting Outcome in Intensive Care Unit-Admitted COVID-19 Patients: Using Clinical, Laboratory, and Radiologic Characteristics.
Factors Predicting Outcome in Intensive Care Unit-Admitted COVID-19 Patients: Using Clinical, Laboratory, and Radiologic Characteristics.
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DOI：
10.1155/2021/9941570
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发表时间：
2021
影响因子：
1.7
通讯作者：
Salahshour F
中科院分区：
文献类型：
--
作者：
Abkhoo A;Shaker E;Mehrabinejad MM;Azadbakht J;Sadighi N;Salahshour F
调查导致重症监护病房 (ICU) 收治的 2019 冠状病毒病 (COVID-19) 患者死亡的因素，并设计预测死亡率的模型。 我们回顾性评估了 ICU 收治的 COVID-19 患者的病历和 CT 图像，这些患者在入院时进行了胸部 CT 扫描。我们分析了患者的人口统计学、临床、实验室和放射学检查结果，并对幸存者和非幸存者进行了比较。 121例入组患者（平均年龄62.2±14.0岁，男性82例（67.8%））中，存活41例（33.9%），其余死亡。最常见的放射学检查结果是毛玻璃样混浊（GGO）（71.9%），伴有外周（38.8%）和双侧（98.3%）受累，以下叶（94.2%）为主。最常见的其他发现是心脏扩大（63.6%）、实质带（47.9%）和疯狂铺路模式（44.4%）。放射学检查结果的单变量分析显示，非幸存者中心脏扩大（p：0.04）、胸腔积液（p：0.02）和心包积液（p：0.03）明显更为常见。然而，两个亚组之间肺部受累的范围没有显着差异（幸存者为 11.4±4.1，非幸存者为 11.9±5.1，p：0.59）。在非放射学因素中，高龄（p：0.002）、较低的氧饱和度（p：0.01）、舒张压（p：0.02）和高血压（p：0.03）在非幸存者中更常见。就实验室检查结果而言，幸存者和非幸存者之间没有显着差异。以下三个因素在后向逻辑回归模型中仍然显着：O2饱和度（OR：0.91（95％CI：0.84-0.97），p：0.006）、心包积液（6.56（0.17-59.3），p：0.09）和高血压（4.11（1.39-12.2），p：0.01）。该模型预测 ICU 死亡率的敏感性为 78.7%，特异性为 61.1%，阳性预测值为 90.0%，准确度为 75.5%。 基础疾病、生命体征和放射学因素的结合可能对 ICU 收治的 COVID-19 患者的死亡率预测具有预后价值。
To investigate the factors contributing to mortality in coronavirus disease 2019 (COVID-19) patients admitted in the intensive care unit (ICU) and design a model to predict the mortality rate. We retrospectively evaluated the medical records and CT images of the ICU-admitted COVID-19 patients who had an on-admission chest CT scan. We analyzed the patients' demographic, clinical, laboratory, and radiologic findings and compared them between survivors and nonsurvivors. Among the 121 enrolled patients (mean age, 62.2 ± 14.0 years; male, 82 (67.8%)), 41 (33.9%) survived, and the rest succumbed to death. The most frequent radiologic findings were ground-glass opacity (GGO) (71.9%) with peripheral (38.8%) and bilateral (98.3%) involvement, with lower lobes (94.2%) predominancy. The most common additional findings were cardiomegaly (63.6%), parenchymal band (47.9%), and crazy-paving pattern (44.4%). Univariable analysis of radiologic findings showed that cardiomegaly (p : 0.04), pleural effusion (p : 0.02), and pericardial effusion (p : 0.03) were significantly more prevalent in nonsurvivors. However, the extension of pulmonary involvement was not significantly different between the two subgroups (11.4 ± 4.1 in survivors vs. 11.9 ± 5.1 in nonsurvivors, p : 0.59). Among nonradiologic factors, advanced age (p : 0.002), lower O2 saturation (p : 0.01), diastolic blood pressure (p : 0.02), and hypertension (p : 0.03) were more commonly found in nonsurvivors. There was no significant difference between survivors and nonsurvivors in terms of laboratory findings. Three following factors remained significant in the backward logistic regression model: O2 saturation (OR: 0.91 (95% CI: 0.84–0.97), p : 0.006), pericardial effusion (6.56 (0.17–59.3), p : 0.09), and hypertension (4.11 (1.39–12.2), p : 0.01). This model had 78.7% sensitivity, 61.1% specificity, 90.0% positive predictive value, and 75.5% accuracy in predicting in-ICU mortality. A combination of underlying diseases, vital signs, and radiologic factors might have prognostic value for mortality rate prediction in ICU-admitted COVID-19 patients.
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DOI：
10.1016/j.redar.2020.07.003
发表时间：
2020-10-01
影响因子：
1.3
作者：
Ferrando, C.;Mellado-Artigas, R.;Hernandez-Sanz, M. L.
通讯作者：
Hernandez-Sanz, M. L.
影响因子：
3.7
作者：
Hu, Yiqi;Zhan, Chenao;Xia, Liming
通讯作者：
Xia, Liming
影响因子：
15.1
作者：
Garcia, Pedro David Wendel;Fumeaux, Thierry;Hilty, Matthias Peter
通讯作者：
Hilty, Matthias Peter
影响因子：
8.9
作者：
Carotti, Marina;Salaffi, Fausto;Giovagnoni, Andrea
通讯作者：
Giovagnoni, Andrea
影响因子：
--
作者：
Sadeghi M;Saberian P;Hasani-Sharamin P;Dadashi F;Babaniamansour S;Aliniagerdroudbari E
通讯作者：
Aliniagerdroudbari E