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中国局部暴发期间疑似患者 COVID-19 检测的临床风险评分的制定:一项回顾性队列研究。

Development of Clinical Risk Scores for Detection of COVID-19 in Suspected Patients During a Local Outbreak in China: A Retrospective Cohort Study.

机构信息

Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China.

Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China.

出版信息

Int J Public Health. 2022 Sep 6;67:1604794. doi: 10.3389/ijph.2022.1604794. eCollection 2022.

Abstract

To develop and internally validate two clinical risk scores to detect coronavirus disease 2019 (COVID-19) during local outbreaks. Medical records were extracted for a retrospective cohort of 336 suspected patients admitted to Baodi hospital between 27 January to 20 February 2020. Multivariate logistic regression was applied to develop the risk-scoring models, which were internally validated using a 5-fold cross-validation method and Hosmer-Lemeshow (H-L) tests. Fifty-six cases were diagnosed from the cohort. The first model was developed based on seven significant predictors, including age, close contact with confirmed/suspected cases, same location of exposure, temperature, leukocyte counts, radiological findings of pneumonia and bilateral involvement (the mean area under the receiver operating characteristic curve [AUC]:0.88, 95% CI: 0.84-0.93). The second model had the same predictors except leukocyte and radiological findings (AUC: 0.84, 95% CI: 0.78-0.89, Z = 2.56, = 0.01). Both were internally validated using H-L tests and showed good calibration (both > 0.10). Two clinical risk scores to detect COVID-19 in local outbreaks were developed with excellent predictive performances, using commonly measured clinical variables. Further external validations in new outbreaks are warranted.

摘要

开发并内部验证两种临床风险评分模型,以在当地疫情爆发期间检测 2019 年冠状病毒病(COVID-19)。回顾性队列研究纳入了 2020 年 1 月 27 日至 2 月 20 日期间因疑似 COVID-19 入住宝坻医院的 336 例疑似患者的病历资料。应用多变量逻辑回归建立风险评分模型,采用 5 折交叉验证法和 Hosmer-Lemeshow(H-L)检验进行内部验证。从队列中诊断出 56 例病例。第一个模型是基于 7 个有显著预测意义的指标建立的,包括年龄、与确诊/疑似病例的密切接触、暴露地点相同、体温、白细胞计数、肺炎的影像学表现和双侧受累(受试者工作特征曲线下面积 [AUC] 的平均值:0.88,95%CI:0.84-0.93)。第二个模型除了白细胞计数和影像学表现外,其余指标相同(AUC:0.84,95%CI:0.78-0.89,Z=2.56,P=0.01)。两个模型均通过 H-L 检验进行内部验证,显示出良好的校准度(均 P>0.10)。使用常用的临床变量开发了两种临床风险评分模型,用于在当地疫情爆发时检测 COVID-19,具有出色的预测性能。需要在新的疫情爆发中进行进一步的外部验证。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1449/9485465/7a8f7a0c5252/ijph-67-1604794-g001.jpg

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