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用于检测COVID-19住院患者临床病情恶化的早期预警评分的多中心验证

Multicenter validation of Early Warning Scores for detection of clinical deterioration in COVID-19 hospitalized patients.

作者信息

Huespe I A, Bisso I C, Roman E S, Prado E, Gemelli N, Sinner J, Heras M L, Risk M R

机构信息

Intensive Care Unit, Hospital Italiano de Buenos Aires, Argentina.

Instituto de Medicina Traslacional e Ingeniería Biomédica, HIBA, IUHI, CONICET, Buenos Aires, Argentina.

出版信息

Med Intensiva. 2023 Jan;47(1):9-15. doi: 10.1016/j.medin.2021.11.002. Epub 2021 Nov 30.

DOI:10.1016/j.medin.2021.11.002
PMID:34866728
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8629741/
Abstract

OBJECTIVE

Investigate the predictive value of NEWS2, NEWS-C, and COVID-19 Severity Index for predicting intensive care unit (ICU) transfer in the next 24 h.

DESIGN

Retrospective multicenter study.

SETTING

Two third-level hospitals in Argentina.

PATIENTS

All adult patients with confirmed COVID-19, admitted on general wards, excluding patients with non-intubated orders.

INTERVENTIONS

Patients were divided between those who were admitted to ICU and non-admitted. We calculated the three scores for each day of hospitalization.

VARIABLES

We evaluate the calibration and discrimination of the three scores for the outcome ICU admission within 24, 48 h, and at hospital admission.

RESULTS

We evaluate 13,768 days of hospitalizations on general medical wards of 1318 patients. Among these, 126 (9.5%) were transferred to ICU. The AUROC of NEWS2 was 0.73 (95%CI 0.68-0.78) 24 h before ICU admission, and 0.52 (95%CI 0.47-0.57) at hospital admission. The AUROC of NEWS-C was 0.73 (95%CI 0.68-0.78) and 0.52 (95%CI 0.47-0.57) respectively, and the AUROC of COVID-19 Severity Index was 0.80 (95%CI 0.77-0.84) and 0.61 (95%CI 0.58-0.66) respectively. COVID-19 Severity Index presented better calibration than NEWS2 and NEWS-C.

CONCLUSION

COVID-19 Severity index has better calibration and discrimination than NEWS2 and NEWS-C to predict ICU transfer during hospitalization.

摘要

目的

研究国家早期预警评分2（NEWS2）、新冠国家早期预警评分（NEWS-C）和新冠严重程度指数对预测未来24小时内重症监护病房（ICU）转入情况的预测价值。

设计

回顾性多中心研究。

地点

阿根廷的两家三级医院。

患者

所有确诊为新冠病毒病（COVID-19）且入住普通病房的成年患者，不包括有非插管医嘱的患者。

干预措施

将患者分为入住ICU和未入住ICU两组。我们计算了患者住院期间每天的三个评分。

变量

我们评估了这三个评分在24小时、48小时以及入院时对ICU入院结局的校准度和区分度。

结果

我们评估了1318例患者在普通内科病房的13768个住院日。其中，126例（9.5%）被转入ICU。NEWS2在ICU入院前24小时的曲线下面积（AUROC）为0.73（95%置信区间0.68-0.78），入院时为0.52（95%置信区间0.47-0.57）。NEWS-C的AUROC分别为0.73（95%置信区间0.68-0.78）和0.52（95%置信区间0.47-0.57），新冠严重程度指数的AUROC分别为0.80（95%置信区间0.77-0.84）和0.61（95%置信区间0.58-0.66）。新冠严重程度指数的校准度优于NEWS2和NEWS-C。

结论

在预测住院期间的ICU转入情况方面，新冠严重程度指数比NEWS2和NEWS-C具有更好的校准度和区分度。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/582c/8629741/28e8ffdfe595/gr3_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/582c/8629741/cc7fd8c7baa7/gr1_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/582c/8629741/84cd6743ca07/gr2_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/582c/8629741/28e8ffdfe595/gr3_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/582c/8629741/cc7fd8c7baa7/gr1_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/582c/8629741/84cd6743ca07/gr2_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/582c/8629741/28e8ffdfe595/gr3_lrg.jpg

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