Khari Sorour, Salimi Akin Abadi Atefe, Pazokian Marzieh, Yousefifard Mahmoud
Student Research Committee, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Clinical Research Development Center, Shahid Modarres Educational Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Arch Acad Emerg Med. 2022 May 10;10(1):e36. doi: 10.22037/aaem.v10i1.1565. eCollection 2022.
Outcome prediction of intensive care unit (ICU)-admitted patients is one of the important issues for physicians. This study aimed to compare the accuracy of Quick Sequential Organ Failure Assessment (qSOFA), Confusion, Urea, Respiratory Rate, Blood Pressure and Age Above or Below 65 Years (CURB-65), and Systemic Inflammatory Response Syndrome (SIRS) scores in predicting the in-hospital mortality of COVID-19 patients.
This prognostic accuracy study was performed on 225 ICU-admitted patients with a definitive diagnosis of COVID-19 from July to December 2021 in Tehran, Iran. The patients' clinical characteristics were evaluated at the time of ICU admission, and they were followed up until discharge from ICU. The screening performance characteristics of CURB-65, qSOFA, and SIRS in predicting their mortality was compared.
225 patients with the mean age of 63.27±14.89 years were studied (56.89% male). The in-hospital mortality rate of this series of patients was 39.10%. The area under the curve (AUC) of SIRS, CURB-65, and qSOFA were 0.62 (95% CI: 0.55 - 0.69), 0.66 (95% CI: 0.59 - 0.73), and 0.61(95% CI: 0.54 - 0.67), respectively (p = 0.508). In cut-off ≥1, the estimated sensitivity values of SIRS, CURB-65, and qSOFA were 85.23%, 96.59%, and 78.41%, respectively. The estimated specificity of scores were 34.31%, 6.57%, and 38.69%, respectively. In cut-off ≥2, the sensitivity values of SIRS, CURB-65, and qSOFA were evaluated as 39.77%, 87.50%, and 15.91%, respectively. Meanwhile, the specificity of scores were 72.99%, 34.31%, and 92.70%.
It seems that the performance of SIRS, CURB-65, and qSOFA is similar in predicting the ICU mortality of COVID-19 patients. However, the sensitivity of CURB-65 is higher than qSOFA and SIRS.
重症监护病房（ICU）收治患者的预后预测是医生面临的重要问题之一。本研究旨在比较快速序贯器官衰竭评估（qSOFA）、意识障碍、尿素、呼吸频率、血压及年龄≥65岁或<65岁（CURB-65）和全身炎症反应综合征（SIRS）评分在预测新型冠状病毒肺炎（COVID-19）患者院内死亡率方面的准确性。
本预后准确性研究对2021年7月至12月在伊朗德黑兰确诊为COVID-19并入住ICU的225例患者进行。在患者入住ICU时评估其临床特征，并对其进行随访直至从ICU出院。比较CURB-65、qSOFA和SIRS在预测患者死亡率方面的筛查性能特征。
共研究了225例患者，平均年龄为63.27±14.89岁（男性占56.89%）。该系列患者的院内死亡率为39.10%。SIRS、CURB-65和qSOFA的曲线下面积（AUC）分别为0.62（95%可信区间：0.55 - 0.69）、0.66（95%可信区间：0.59 - 0.73）和0.61（95%可信区间：0.54 - 0.67）（p = 0.508）。在临界值≥1时，SIRS、CURB-65和qSOFA的估计灵敏度值分别为85.23%、96.59%和78.41%。各评分的估计特异性分别为34.31%、6.5
