Carmo Thomas A, Ferreira Isabella B B, Menezes Rodrigo C, Pina Márcio L T, Oliveira Roberto S, Telles Gabriel P, Machado Antônio F A, Aguiar Tércio C, Caldas Juliana R, Arriaga María B, Akrami Kevan M, Filgueiras Filho Nivaldo M, Andrade Bruno B
Universidade Salvador (UNIFACS), Salvador, Bahia, Brazil.
Multinational Organization Network Sponsoring Translational and Epidemiological Research Initiative, Salvador, Brazil.
Front Med (Lausanne). 2022 Aug 15;9:958291. doi: 10.3389/fmed.2022.958291. eCollection 2022.
Prognostic tools developed to stratify critically ill patients in Intensive Care Units (ICUs), are critical to predict those with higher risk of mortality in the first hours of admission. This study aims to evaluate the performance of the pShock score in critically ill patients admitted to the ICU with SARS-CoV-2 infection.
Prospective observational analytical cohort study conducted between January 2020 and March 2021 in four general ICUs in Salvador, Brazil. Descriptive statistics were used to characterize the cohort and a logistic regression, followed by cross-validation, were performed to calibrate the score. A ROC curve analysis was used to assess accuracy of the models analyzed.
Six hundred five adult ICU patients were included in the study. The median age was 63 (IQR: 49-74) years with a mortality rate of 33.2% (201 patients). The calibrated pShock-CoV score performed well in prediction of ICU mortality (AUC of 0.80 [95% Confidence Interval (CI): 0.77-0.83; -value < 0.0001]).
The pShock-CoV score demonstrated robust discriminatory capacity and may assist in targeting scarce ICU resources during the COVID-19 pandemic to those critically ill patients most likely to benefit.
为重症监护病房（ICU）中病情危急的患者进行分层而开发的预后评估工具，对于预测入院后最初几小时内死亡风险较高的患者至关重要。本研究旨在评估pShock评分在因感染SARS-CoV-2而入住ICU的重症患者中的性能。
2020年1月至2021年3月在巴西萨尔瓦多的四个普通ICU进行前瞻性观察性分析队列研究。使用描述性统计来描述该队列特征，并进行逻辑回归分析及交叉验证以校准该评分。采用ROC曲线分析来评估所分析模型的准确性。
本研究纳入了605例成年ICU患者。中位年龄为63岁（四分位间距：49 - 74岁），死亡率为33.2%（201例患者）。校准后的pShock-CoV评分在预测ICU死亡率方面表现良好（AUC为0.80 [95%置信区间（CI）：0.77 - 0.83；P值<0.0001]）。
pShock-CoV评分显示出强大的鉴别能力，可能有助于在新冠疫情期间将ICU稀缺资源分配给最有可能受益的重症患者。
