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急诊科诊断为 COVID-19 患者的死亡率预测因素:心电图、实验室和 CT。

Mortality Predictors in Patients Diagnosed with COVID-19 in the Emergency Department: ECG, Laboratory and CT.

机构信息

Department of Emergency Medicine, Faculty of Medicine, Alanya Alaaddin Keykubat University, Antalya 07450, Turkey.

Department of Radiology, Faculty of Medicine, Alanya Alaaddin Keykubat University, Antalya 07450, Turkey.

出版信息

Medicina (Kaunas). 2021 Jun 17;57(6):629. doi: 10.3390/medicina57060629.

Abstract

: The aim of this study was to investigate parameters that can be used to predict mortality in patients diagnosed with COVID-19 in the emergency department (ED). : Patients diagnosed with COVID-19 in the ED were included in this prospective study. The patients were divided into two groups. The surviving patients were included in Group 1 (survivors), and the patients who died were included in Group 2 (non-survivors). The electrocardiogram (ECG), laboratory results and chest computerized tomography (CCT) findings of the two groups were compared. The CCT images were classified according to the findings as normal, mild, moderate and severe. : Of the 419 patients included in the study, 347 (83%) survived (survivor) and 72 (17%) died (non-survivor). The heart rate and respiratory rate were found to be higher, and the peripheral oxygen saturation (SpO) and diastolic blood pressure (DBP) were found to be lower in the non-survivor patients. QRS and corrected QT interval (QTc) were measured as longer in the non-survivor patients. In the CCT images, 79.2% of the non-survivor patients had severe findings, while 11.5% of the survivor patients had severe findings. WBC, neutrophil, NLR, lactate, D-dimer, fibrinogen, C- Reactive Protein (CRP), urea, creatinine, creatine kinase-MB (CK-MB) and hs-Troponin I levels were found to be higher and partial pressure of carbon dioxide (PCO, base excess (BE), bicarbonate (HCO, lymphocyte eosinophil levels were found to be lower in non-survivor patients. The highest AUC was calculated at the SpO level and the eosinophil level. : COVID-19 is a fatal disease whose mortality risk can be estimated when the clinical, laboratory and imaging studies of the patients are evaluated together in the ED. SpO that is measured before starting oxygen therapy, the eosinophil levels and the CT findings are all important predictors of mortality risk.

摘要

: 本研究旨在探讨可用于预测急诊科(ED)诊断为 COVID-19 患者死亡的参数。: 在这项前瞻性研究中,纳入了在 ED 诊断为 COVID-19 的患者。将患者分为两组。存活的患者被纳入第 1 组(存活者),死亡的患者被纳入第 2 组(非存活者)。比较两组的心电图(ECG)、实验室结果和胸部计算机断层扫描(CCT)结果。根据结果对 CCT 图像进行分类,分为正常、轻度、中度和重度。: 在纳入研究的 419 名患者中,347 名(83%)存活(存活者),72 名(17%)死亡(非存活者)。非存活者的心率和呼吸频率较高,外周血氧饱和度(SpO)和舒张压(DBP)较低。非存活者的 QRS 和校正 QT 间期(QTc)较长。在 CCT 图像中,79.2%的非存活者有严重表现,而 11.5%的存活者有严重表现。白细胞计数(WBC)、中性粒细胞、中性粒细胞与淋巴细胞比值(NLR)、乳酸、D-二聚体、纤维蛋白原、C-反应蛋白(CRP)、尿素、肌酐、肌酸激酶同工酶-MB(CK-MB)和高敏肌钙蛋白 I 水平较高,而非存活者的二氧化碳分压(PCO)、碱剩余(BE)、碳酸氢盐(HCO)、淋巴细胞和嗜酸性粒细胞水平较低。SpO 水平和嗜酸性粒细胞水平的 AUC 最高。: COVID-19 是一种致命疾病,当综合评估患者的临床、实验室和影像学检查时,可以在急诊科评估其死亡风险。在开始吸氧治疗之前测量的 SpO、嗜酸性粒细胞水平和 CT 发现都是死亡风险的重要预测指标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/484c/8233881/79e33e043dac/medicina-57-00629-g001.jpg

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