Fellow, Radiology, The Royal Oldham Hospital (Northern Care Alliance), UK.
Radiologist, The Pennine Acute Hospitals NHS Trust, UK.
Scott Med J. 2021 Aug;66(3):101-107. doi: 10.1177/00369330211027447. Epub 2021 Jun 26.
To devise a novel, simple chest x-ray (CXR) scoring system which would help in prognosticating the disease severity and ability to predict comorbidities and in-hospital mortality.
We included a total of 343 consecutive hospitalised patients with COVID-19 in this study. The chest x-rays of these patients were scored retrospectively by three radiologists independently. We divided CXR in to six zones (right upper, mid & lower and left, upper mid & lower zones). We scored each zone as- 0, 1 or 2 as follows- if that zone was clear (0) Ground glass opacity (1) or Consolidation (2). A total of score from 0 to 12 could be obtained.
A CXR score cut off ≥3 independently predicted mortality. Along with a relatively higher NPV ≥80%, it reinforced the importance of CXR score is a screening tool to triage patients according to risk of mortality.
We propose that Pennine score is a simple tool which can be adapted by various countries, experiencing a large surge in number of patients, to decide which patient would need a tertiary Hospital referral/admission as opposed to patients that can be managed locally or at basic/primary care hospitals.
设计一种新颖、简单的胸部 X 线（CXR）评分系统，有助于预测疾病严重程度，并预测合并症和住院死亡率。
我们将总共 343 名连续住院的 COVID-19 患者纳入本研究。由三名放射科医生对这些患者的胸部 X 射线进行回顾性评分。我们将 CXR 分为六个区域（右侧上、中、下和左侧上、中、下区域）。我们对每个区域进行评分，如下所示：如果该区域清晰（0）、磨玻璃影（1）或实变（2）。总分为 0 到 12 分。
CXR 评分≥3 可独立预测死亡率。同时具有相对较高的 NPV≥80%，这强化了 CXR 评分作为一种筛查工具的重要性，可根据死亡率风险对患者进行分诊。
我们提出 Pennine 评分是一种简单的工具，可以被许多国家采用，这些国家面临大量患者涌入的情况，以决定哪些患者需要转诊/住院到三级医院，而哪些患者可以在当地或基本/初级保健医院进行管理。
