Asmarawati Tri Pudy, Suryantoro Satriyo Dwi, Rosyid Alfian Nur, Marfiani Erika, Windradi Choirina, Mahdi Bagus Aulia, Sutanto Heri
Department of Internal Medicine, Universitas Airlangga, Faculty of Medicine, Surabaya, East Java, Indonesia.
Department of Pulmonary and Respiratory Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia.
Indian J Crit Care Med. 2022 Summer;26(4):464-471. doi: 10.5005/jp-journals-10071-24170.
Various mortality predictive score models for coronavirus disease-2019 (COVID-19) have been deliberated. We studied how sequential organ failure assessment (SOFA), quick sequential organ failure assessment (qSOFA), acute physiology and chronic health evaluation II (APACHE II), and new early warning signs (NEWS-2) scores estimate mortality in COVID-19 patients.
We conducted a prospective cohort study of 53 patients with moderate-to-severe COVID-19. We calculated qSOFA, SOFA, APACHE II, and NEWS-2 on initial admission and re-evaluated on day 5. We performed logistic regression analysis to differentiate the predictors of qSOFA, SOFA, APACHE II, and NEWS-2 scores on mortality.
qSOFA, SOFA, APACHE II, and NEWS-2 scores on day 5 exhibited a difference between survivors and nonsurvivors ( <0.05), also between ICU and non-ICU admission ( <0.05). The initial NEWS-2 revealed a higher AUC value than the qSOFA, APACHE II, and SOFA score in estimating mortality (0.867; 0.83; 0.822; 0.794). In ICU, APACHE II score revealed a higher AUC value than the SOFA, NEWS-2, and qSOFA score (0.853; 0.832; 0.813; 0.809). Concurrently, evaluation on day 5 showed that qSOFA AUC had higher scores than the NEWS-2, APACHE II, and SOFA (0.979; 0.965; 0.939; 0.933) in predicting mortality, while SOFA and APACHE II AUC were higher in ICU admission than NEWS-2 and qSOFA (0.968; 0.964; 0.939; 0.934). According to the cutoff score, APACHE II on day 5 revealed the highest sensitivity and specificity in predicting the mortality (sensitivity 95.7%, specificity 86.7%).
All scores signify good predictive values on COVID-19 patients mortality following the evaluation on the day 5. Nonetheless, APACHE-II appears to be the best at predicting mortality and ICU admission rate.
Asmarawati TP, Suryantoro SD, Rosyid AN, Marfiani E, Windradi C, Mahdi BA, Predictive Value of Sequential Organ Failure Assessment, Quick Sequential Organ Failure Assessment, Acute Physiology and Chronic Health Evaluation II, and New Early Warning Signs Scores Estimate Mortality of COVID-19 Patients Requiring Intensive Care Unit. Indian J Crit Care Med 2022;26(4):464-471.
针对2019冠状病毒病（COVID-19），人们已经探讨了多种死亡率预测评分模型。我们研究了序贯器官衰竭评估（SOFA）、快速序贯器官衰竭评估（qSOFA）、急性生理与慢性健康状况评分系统II（APACHE II）以及新预警评分（NEWS-2）对COVID-19患者死亡率的评估情况。
我们对53例中重度COVID-19患者进行了一项前瞻性队列研究。在患者初次入院时计算qSOFA、SOFA、APACHE II和NEWS-2评分，并在第5天进行重新评估。我们进行了逻辑回归分析，以区分qSOFA、SOFA、APACHE II和NEWS-2评分对死亡率的预测因素。
第5天的qSOFA、SOFA、APACHE II和NEWS-2评分在幸存者和非幸存者之间存在差异（P<0.05），在入住重症监护病房（ICU）和未入住ICU的患者之间也存在差异（P<0.05）。初始的NEWS-2评分在估计死亡率方面的曲线下面积（AUC）值高于qSOFA、APACHE II和SOFA评分（分别为0.867、0.83、0.822、0.794）。在ICU中，APACHE II评分的AUC值高于SOFA、NEWS-2和qSOFA评分（分别为0.853、0.832、0.813、0.809）。同时，第5天的评估显示，在预测死亡率方面，qSOFA的AUC评分高于NEWS-2、APACHE II和SOFA（分别为0.979、0.965、0.939、0.933），而在入住ICU方面，SOFA和APACHE II的AUC高于NEWS-2和qSOFA（分别为0.968、0.964、0.939、0.934）。根据截断分数，第5天的APACHE II在预测死亡率方面显示出最高的敏感性和特异性（敏感性95.7%，特异性86.7%）。
在第5天进行评估后，所有评分对COVID-19患者的死亡率均显示出良好的预测价值。尽管如此，APACHE-II在预测死亡率和ICU入住率方面似乎表现最佳。
阿斯马拉瓦蒂TP，苏延托罗SD，罗西德AN，马尔菲亚尼E，温德拉迪C，马赫迪BA，序贯器官衰竭评估、快速序贯器官衰竭评估、急性生理与慢性健康状况评分系统II以及新预警评分对需要重症监护病房的COVID-19患者死亡率的预测价值。《印度危重症医学杂志》2022；26(4)：464-471。
