NEWS2 + 乳酸 + D - 二聚体在预测COVID - 19患者入住重症监护病房及院内死亡率中的作用

The Role of NEWS2 + Lactate + D-Dimer in Predicting Intensive Care Unit Admission and In-Hospital Mortality of COVID-19 Patients.

作者信息

Küçükceran Kadir, Ayrancı Mustafa Kürşat, Dündar Zerrin Defne, Keklik Muhammed İdris, Vatansev Hülya

机构信息

Necmettin Erbakan University Emergency Department Meram School of Medicine, Konya Turkey.

Necmettin Erbakan University Department of Chest Disease Meram School of Medicine, Konya Turkey.

出版信息

J Acute Med. 2022 Jun 1;12(2):60-70. doi: 10.6705/j.jacme.202206_12(2).0003.

DOI:10.6705/j.jacme.202206_12(2).0003

PMID:35860710

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9283119/

Abstract

BACKGROUND

We investigated the parameters of National Early Warning Score 2 (NEWS2) + lactate + D-dimer in predicting the intensive care unit (ICU) admission and in-hospital mortality in patients hospitalized with COVID-19.

METHODS

Patients, who applied to the emergency department of a tertiary university hospital and were taken to the COVID-19 zone with suspected COVID-19 between March 2020 and June 2020, were retrospectively examined. In this study, 244 patients, who were hospitalized and had positive polymerase chain reaction test results, were included. NEWS2, lactate, and D-dimer levels of the patients were recorded. Patients were grouped by the states of in-hospital mortality and ICU admission.

RESULTS

Of 244 patients who were included in the study, 122 (50%) were male, while their mean age was 53.76 ± 17.36 years. 28 (11.5%) patients were admitted to the ICU, while in-hospital mortality was seen in 14 (5.7%) patients. The levels of D-dimer, NEWS2, NEWS2 + lactate, NEWS2 + D-dimer, NEWS2 + lactate + D-dimer were statistically significantly higher in patients with in-hospital mortality and admitted to ICU ( < 0.05). The area under the curve (AUC) values of D-dimer, lactate, NEWS2, NEWS2 + lactate, NEWS2 + D-dimer, NEWS2 + lactate + D-dimer in predicting ICU admission were as 0.745 (0.658-0.832), 0.589 (0.469-0.710), 0.760 (0.675-0.845), 0.774 (0.690-0.859), 0.776 (0.692-0.860), and 0.778 (0.694-0.862), respectively; while the AUC values of these parameters in predicting in-hospital mortality were found to be as 0.768 (0.671-0.865), 0.695 (0.563-0.827), 0.735 (0.634-0.836), 0.757 (0.647-0.867), 0.752 (0.656-0.848), and 0.764 (0.655-0.873), respectively.

CONCLUSIONS

Compared to using the NEWS2 value alone, a combination of NEWS2, lactate, and D-dimer was found to be more valuable in predicting in-hospital mortality and ICU admission.

摘要

背景

我们研究了国家早期预警评分2（NEWS2）+乳酸+D-二聚体在预测新型冠状病毒肺炎（COVID-19）住院患者入住重症监护病房（ICU）及院内死亡率方面的参数。

方法

回顾性分析2020年3月至2020年6月期间因疑似COVID-19到一所三级大学医院急诊科就诊并被送至COVID-19专区的患者。本研究纳入了244例住院且聚合酶链反应检测结果呈阳性的患者。记录患者的NEWS2、乳酸和D-二聚体水平。根据院内死亡率和ICU入住情况对患者进行分组。

结果

纳入研究的244例患者中，122例（50%）为男性，平均年龄为53.76±17.36岁。28例（11.5%）患者入住ICU，14例（5.7%）患者出现院内死亡。院内死亡和入住ICU的患者中，D-二聚体、NEWS2、NEWS2+乳酸、NEWS2+D-二聚体、NEWS2+乳酸+D-二聚体水平在统计学上显著更高（P<0.05）。D-二聚体、乳酸、NEWS2、NEWS2+乳酸、NEWS2+D-二聚体、NEWS2+乳酸+D-二聚体预测ICU入住的曲线下面积（AUC）值分别为0.745（0.658-0.832）、0.589（0.469-0.710）、0.760（0.675-0.845）、0.774（0.690-0.859）、0.776（0.692-0.860）和0.778（0.694-0.862）；而这些参数预测院内死亡率的AUC值分别为0.768（0.671-0.865）、0.695（0.563-0.827）、0.735（0.634-0.836）、0.757（0.647-0.867）、0.752（0.656-0.848）和0.764（0.655-0.873）。