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新冠肺炎危重症患者死亡危险因素分析及列线图构建。

Risk Factor Analysis and Nomogram Construction for Non-Survivors among Critical Patients with COVID-19.

机构信息

Department of Radiology, Zhongnan Hospital of Wuhan University, China.

出版信息

Jpn J Infect Dis. 2020 Nov 24;73(6):452-458. doi: 10.7883/yoken.JJID.2020.227. Epub 2020 Jun 30.

Abstract

The outbreak of the coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2, occurred in China in December 2019. This disease has caused more than 70,000 deaths worldwide. We intend to analyze the risk factors of death and establish a prognosis nomogram for critical patients with COVID-19. We analyzed the clinical data of COVID-19 patients in Zhongnan Hospital of Wuhan University who were in the critical state before March 20, 2020. Data were collected on admission and compared between survivors and non-survivors and analyzed by univariable and multivariable logistic regression analyses. Finally, 104 patients were included, 50 of whom died. Age (odds ratio, OR 5.73 [95% confidence interval, CI, 1.14-28.81]), chest tightness (OR 5.50 [95% CI, 1.02-9.64]), AST (OR 6.57 [95% CI, 1.33-32.48]), and blood urea nitrogen (5.59 [95% CI, 1.05-29.74]) at admission were considered predictors of the risk of death in critical patients and were selected to construct the nomogram. Subsequently, we established a nomogram model and validated it. The sensitivity and specificity of the nomogram were 96.0% and 74.1%, respectively. The area under the curve was 0.893 (95% CI, 0.807-0.980).

摘要

2019 年冠状病毒病(COVID-19)的爆发是由严重急性呼吸系统综合征冠状病毒 2 引起的,于 2019 年 12 月在中国发生。这种疾病已在全球范围内造成超过 70000 人死亡。我们旨在分析死亡的危险因素,并为 COVID-19 重症患者建立预后列线图。我们分析了 2020 年 3 月 20 日前在武汉大学中南医院处于危急状态的 COVID-19 患者的临床数据。收集入院时的数据,并在幸存者和非幸存者之间进行比较,并通过单变量和多变量逻辑回归分析进行分析。最终,纳入了 104 例患者,其中 50 例死亡。年龄(优势比,OR5.73[95%置信区间,CI1.14-28.81])、胸闷(OR5.50[95%CI1.02-9.64])、AST(OR6.57[95%CI1.33-32.48])和入院时的血尿素氮(5.59[95%CI1.05-29.74])被认为是重症患者死亡风险的预测因素,并被选入构建列线图。随后,我们建立了一个列线图模型并进行了验证。该列线图的灵敏度和特异性分别为 96.0%和 74.1%,曲线下面积为 0.893(95%CI0.807-0.980)。

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