Division of Respiratory Diseases, Department of Internal Medicine, Atsugi City Hospital, Japan.
Division of Respiratory Diseases, Department of Internal Medicine, The Jikei University School of Medicine, Japan.
Intern Med. 2022 Jul 15;61(14):2135-2141. doi: 10.2169/internalmedicine.9262-21. Epub 2022 May 14.
Objective Coronavirus disease 2019 (COVID-19) has caused a collapse of the medical care system, with effective triage proving vital. The Kanagawa admission priority assessment score, version-1 (KAPAS-1) and version-2 (KAPAS-2), was developed to determine the need for hospitalization. Patients with a high KAPAS (≥5) are recommended for hospitalization. We retrospectively investigated the correlation between the KAPAS and oxygen requirement during hospitalization. Methods We collected the clinical data of COVID-19 patients admitted between February 5 and December 6, 2020. Patients were divided into two groups: those who required oxygen therapy during hospitalization (OXY) and those who did not (NOXY). We assessed the correlations between the groups and KAPAS-1 and KAPAS-2. Results Overall, 117 COVID-19 patients were analyzed, including 20 OXY and 97 NOXY and 54 high KAPAS-1 and 63 high KAPAS-2. The median KAPAS-1 and KAPAS-2 were significantly higher in OXY than in NOXY (6.5 vs. 3, and 9 vs. 4, respectively). The areas under the receiver operating characteristic curves of KAPAS-1 and KAPAS-2 for oxygen requirement were 0.777 and 0.825, respectively, and the maximum values of Youden's index were 4 and 6, respectively. The proportions of high KAPAS-1 and high KAPAS-2 were significantly higher in OXY than in NOXY (90.0% vs. 37.1%, and 90.0% vs. 46.4%, respectively). Conclusion The KAPAS was significantly correlated with oxygen requirement. Furthermore, the KAPAS may be useful for deciding which patients are most likely to require hospitalization and for selecting non-hospitalized patients who should be carefully monitored.
目的
2019 年冠状病毒病(COVID-19)导致医疗体系崩溃,有效的分诊至关重要。为了确定住院需求,开发了 Kanagawa 入院优先级评估评分(KAPAS)版本 1(KAPAS-1)和版本 2(KAPAS-2)。KAPAS 较高(≥5)的患者建议住院。我们回顾性调查了 KAPAS 与住院期间氧气需求之间的相关性。
方法
我们收集了 2020 年 2 月 5 日至 12 月 6 日期间住院的 COVID-19 患者的临床数据。患者分为两组:住院期间需要氧疗(OXY)和不需要氧疗(NOXY)的患者。我们评估了两组之间以及 KAPAS-1 和 KAPAS-2 之间的相关性。
结果
共分析了 117 例 COVID-19 患者,其中 20 例为 OXY,97 例为 NOXY,54 例 KAPAS-1 较高,63 例 KAPAS-2 较高。OXY 组的 KAPAS-1 和 KAPAS-2 的中位数均明显高于 NOXY 组(分别为 6.5 与 3,9 与 4)。KAPAS-1 和 KAPAS-2 对氧需求的受试者工作特征曲线下面积分别为 0.777 和 0.825,Youden 指数的最大值分别为 4 和 6。OXY 组的高 KAPAS-1 和高 KAPAS-2 比例明显高于 NOXY 组(分别为 90.0%比 37.1%,90.0%比 46.4%)。
结论
KAPAS 与氧需求显著相关。此外,KAPAS 可能有助于决定哪些患者最有可能需要住院,并选择需要密切监测的非住院患者。