Internal Medicine, Busto Arsizio Hospital, ASST Valle Olona, Busto Hospital, Varese, Lombardy, Italy.
Vascular Surgery, ASST Valle Olona, Busto Hospital, Varese, Lombardy, Italy.
Intern Emerg Med. 2020 Nov;15(8):1409-1414. doi: 10.1007/s11739-020-02480-3. Epub 2020 Sep 15.
The epidemic phase of Coronavirus disease 2019 (COVID-19) made the Worldwide health system struggle against a severe interstitial pneumonia requiring high-intensity care settings for respiratory failure. A rationalisation of resources and a specific treatment path were necessary. The study suggests a predictive model drawing on clinical data gathered by 119 consecutive patients with laboratory-confirmed COVID-19 admitted in Busto Arsizio hospital. We derived a score that identifies the risk of clinical evolution and in-hospital mortality clustering patients into four groups. The study outcomes have been compared across the derivation and validation samples. The prediction rule is based on eight simple patient characteristics that were independently associated with study outcomes. It is able to stratify COVID-19 patients into four severity classes, with in-hospital mortality rates of 0% in group 1, 6-12.5% in group 2, 7-20% in group 3 and 60-86% in group 4 across the derivation and validation sample. The prediction model derived in this study identifies COVID-19 patients with low risk of in-hospital mortality and ICU admission. The prediction model that the study presents identifies COVID-19 patients with low risk of in-hospital mortality and admission to ICU. Moreover, it establishes an intermediate portion of patients that should be treated accurately in order to avoid an unfavourable clinical evolution. A further validation of the model is important before its implementation as a decision-making tool to guide the initial management of patients.
2019 年冠状病毒病(COVID-19)的流行阶段使全球卫生系统与需要高强度护理设置以治疗呼吸衰竭的严重间质性肺炎作斗争。需要对资源进行合理化,并制定特定的治疗路径。该研究提出了一种基于在布托·阿尔齐奥医院(Busto Arsizio hospital)收治的 119 例经实验室确诊的 COVID-19 连续患者的临床数据的预测模型。我们得出了一个评分,该评分可识别临床进展和住院死亡率的风险,将患者聚类为四个组。研究结果在推导和验证样本中进行了比较。预测规则基于与研究结果独立相关的八个简单患者特征。它能够将 COVID-19 患者分为四个严重程度类别,在推导和验证样本中,第 1 组的住院死亡率为 0%,第 2 组为 6-12.5%,第 3 组为 7-20%,第 4 组为 60-86%。本研究中得出的预测模型可识别出低住院死亡率和 ICU 入院风险的 COVID-19 患者。该研究提出的预测模型可识别出低住院死亡率和 ICU 入院风险的 COVID-19 患者。此外,它确定了一部分需要准确治疗的患者,以避免不利的临床进展。在将其用作指导患者初始管理的决策工具之前,对该模型进行进一步验证非常重要。