The Predictive Potential of Elevated Serum Inflammatory Markers in Determining the Need for Intubation in CoVID-19 Patients.
The Predictive Potential of Elevated Serum Inflammatory Markers in Determining the Need for Intubation in CoVID-19 Patients.
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DOI：
10.2478/jccm-2021-0035
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发表时间：
2022-01
期刊：
影响因子：
--
通讯作者：
Erlandson K
中科院分区：
文献类型：
--
作者：
Windham S;Hirsch K;Peterson R;Douin D;Chauhan L;Heery L;Fling C;Vukovic N;Holguin F;Zimmer S;Erlandson K
人口统计学、临床特征和入院时炎症标志物在确定住院 CoVID-19 患者未来插管需求方面的预测潜力尚不清楚。该研究旨在确定血清炎症标志物升高在确定 CoVID-19 患者是否需要插管方面的预测潜力。在一项针对住院 SARS-CoV2 阳性患者的回顾性队列研究中，使用单变量和多变量回归分析来确定对插管几率的协变量影响，并使用极小最大凹罚正则化逻辑回归来构建预测模型。第二个前瞻性独立队列测试了该模型。需要随后插管的患者在入院时获得的全身炎症标志物较高，并且 C 反应蛋白 (CRP) OR:2.8 (95% CI 1.8-4.5，p<0.001) 和乳酸脱氢酶 OR:2.1 (95% CI 1.33.3，p=0.002) 的平均标准差每高于平均值，调整插管的几率就会增加。结合 C 反应蛋白、乳酸脱氢酶和入院时糖尿病状况的预测模型预测插管状态，曲线下面积 (AUC) 为 0.78，相应的敏感性为 86%，特异性为 63%。该预测模型在验证队列中的 AUC 为 0.83，敏感性为 91%，特异性为 41%。在因 CoVID-19 住院的患者中，入院后 24 小时内测得的血清炎症标志物升高与插管需求增加相关。此外，C反应蛋白、乳酸脱氢酶和糖尿病的存在模型可能在确定未来插管的需要方面发挥预测作用。
The predictive potential of demographics, clinical characteristics, and inflammatory markers at admission to determine future intubation needs of hospitalised CoVID-19 patients is unknown. The study aimed to determine the predictive potential of elevated serum inflammatory markers in determining the need for intubation in CoVID-19 Patients. In a retrospective cohort study of hospitalised SARS-CoV2 positive patients, single and multivariable regression analyses were used to determine covariate effects on intubation odds, and a minimax concave penalty regularised logistic regression was used to build a predictive model. A second prospective independent cohort tested the model. Systemic inflammatory markers obtained at admission were higher in patients that required subsequent intubation, and adjusted odds of intubation increased for every standard deviation above the mean for c-reactive protein (CRP) OR:2.8 (95% CI 1.8-4.5, p<0.001) and lactate dehydrogenase OR:2.1 (95% CI 1.33.3, p=0.002). A predictive model incorporating C-reactive protein, lactate dehydrogenase, and diabetes status at the time of admission predicted intubation status with an area under the curve (AUC) of 0.78 with corresponding sensitivity of 86%, specificity of 63%. This predictive model achieved an AUC of 0.83, 91% sensitivity, and 41% specificity on the validation cohort. In patients hospitalised with CoVID-19, elevated serum inflammatory markers measured within the first twenty-four hours of admission are associated with an increased need for intubation. Additionally, a model of C-reactive protein, lactate dehydrogenase, and the presence of diabetes may play a predictive role in determining the future need for intubation.
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DOI：
10.1214/10-aoas388
发表时间：
2011-01-01
期刊：
The annals of applied statistics
影响因子：
--
作者：
Breheny P;Huang J
通讯作者：
Huang J
影响因子：
4.5
作者：
Zhang, Cun-Hui
通讯作者：
Zhang, Cun-Hui
影响因子：
11.8
作者：
Qin, Chuan;Zhou, Luoqi;Tian, Dai-Shi
通讯作者：
Tian, Dai-Shi
影响因子：
39
作者：
Wu, Chaomin;Chen, Xiaoyan;Song, Yuanlin
通讯作者：
Song, Yuanlin
影响因子：
11.8
作者：
Ji, Dong;Zhang, Dawei;Qin, Enqiang
通讯作者：
Qin, Enqiang