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英国地区综合医院收治的 COVID-19 患者的生存预测算法。

Survival prediction algorithms for COVID-19 patients admitted to a UK district general hospital.

机构信息

Medicine Department, Queen's Hospital, Burton-on-Trent, UK.

Clinical Chemistry Department, Queen's Hospital, Burton-on-Trent, UK.

出版信息

Int J Clin Pract. 2021 May;75(5):e13974. doi: 10.1111/ijcp.13974. Epub 2021 Jan 18.

Abstract

OBJECTIVE

To collect and review data from consecutive patients admitted to Queen's Hospital, Burton on Trent for treatment of Covid-19 infection, with the aim of developing a predictive algorithm that can help identify those patients likely to survive.

DESIGN

Consecutive patient data were collected from all admissions to hospital for treatment of Covid-19. Data were manually extracted from the electronic patient record for statistical analysis.

RESULTS

Data, including outcome data (discharged alive/died), were extracted for 487 consecutive patients, admitted for treatment. Overall, patients who died were older, had very significantly lower Oxygen saturation (SpO2) on admission, required a higher inspired Oxygen concentration (IpO2) and higher CRP as evidenced by a Bonferroni-corrected (P < 0.0056). Evaluated individually, platelets and lymphocyte count were not statistically significant but when used in a logistic regression to develop a predictive score, platelet count did add predictive value. The 5-parameter prediction algorithm we developed was: [Formula: see text] CONCLUSION: Age, IpO2 on admission, CRP, platelets and number of lungs consolidated were effective marker combinations that helped identify patients who would be likely to survive. The AUC under the ROC Plot was 0.8129 (95% confidence interval 0.0.773 - 0.853; P < .001).

摘要

目的

收集和分析连续入住伯顿特伦特皇后医院治疗新冠感染的患者数据,旨在开发一种预测算法,以帮助识别可能存活的患者。

设计

连续收集所有因新冠住院治疗的患者数据。从电子病历中手动提取数据进行统计分析。

结果

共提取了 487 名连续入院患者的数据,包括结局数据(存活出院/死亡)。总体而言,死亡患者年龄更大,入院时氧饱和度(SpO2)显著降低,需要更高的吸入氧浓度(IpO2),C 反应蛋白(CRP)更高,经 Bonferroni 校正(P < 0.0056)。单独评估时,血小板和淋巴细胞计数无统计学意义,但在使用逻辑回归开发预测评分时,血小板计数确实增加了预测价值。我们开发的 5 个参数预测算法为:[公式:见正文]。

结论

年龄、入院时的 IpO2、CRP、血小板和肺部实变数量是有助于识别可能存活患者的有效标志物组合。ROC 曲线下面积为 0.8129(95%置信区间 0.773-0.853;P < 0.001)。

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