改良SCOPE（mSCOPE）评分作为预测COVID-19危重症患者死亡率的工具。
Modified SCOPE (mSCOPE) Score as a Tool to Predict Mortality in COVID-19 Critically Ill Patients.
作者信息
Zanelli Stavroula, Bakakos Agamemnon, Sotiropoulou Zoi, Papaioannou Andriana I, Koukaki Evangelia, Potamianou Efstathia, Kyriakoudi Anna, Kaniaris Evangelos, Bakakos Petros, Giamarellos-Bourboulis Evangelos J, Koutsoukou Antonia, Rovina Nikoletta
机构信息
1st Respiratory Department, Medical School, National and Kapodistrian University of Athens, "Sotiria" Chest Hospital, 11527 Athens, Greece.
4th Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, "Attikon" Hospital, 12462 Athens, Greece.
出版信息
J Pers Med. 2023 Apr 2;13(4):628. doi: 10.3390/jpm13040628.
INTRODUCTION
Efficient clinical scores predicting the outcome of severe COVID-19 pneumonia may play a pivotal role in patients' management. The aim of this study was to assess the modified Severe COvid Prediction Estimate score (mSCOPE) index as a predictor of mortality in patients admitted to the ICU due to severe COVID-19 pneumonia.
MATERIALS AND METHODS
In this retrospective observational study, 268 critically ill COVID-19 patients were included. Demographic and laboratory characteristics, comorbidities, disease severity, and outcome were retrieved from the electronical medical files. The mSCOPE was also calculated.
RESULTS
An amount of 70 (26.1%) of patients died in the ICU. These patients had higher mSCOPE score compared to patients who survived ( < 0.001). mSCOPE correlated to disease severity ( < 0.001) and to the number and severity of comorbidities ( < 0.001). Furthermore, mSCOPE significantly correlated with days on mechanical ventilation ( < 0.001) and days of ICU stay ( = 0.003). mSCOPE was found to be an independent predictor of mortality (HR:1.219, 95% CI: 1.010-1.471, = 0.039), with a value ≥ 6 predicting poor outcome with a sensitivity (95%CI) 88.6%, specificity 29.7%, a positive predictive value of 31.5%, and a negative predictive value of 87.7%.
CONCLUSION
mSCOPE score could be proved useful in patients' risk stratification, guiding clinical interventions in patients with severe COVID-19.
引言
有效的临床评分可预测重症新型冠状病毒肺炎（COVID-19）的预后，这在患者管理中可能发挥关键作用。本研究旨在评估改良的重症新型冠状病毒肺炎预测估计评分（mSCOPE）指数，作为因重症COVID-19肺炎入住重症监护病房（ICU）患者死亡率的预测指标。
材料与方法
在这项回顾性观察研究中，纳入了268例危重症COVID-19患者。从电子病历中获取人口统计学和实验室特征、合并症、疾病严重程度及预后情况。同时计算mSCOPE评分。
结果
70例（26.1%）患者在ICU死亡。与存活患者相比，这些患者的mSCOPE评分更高（<0.001）。mSCOPE与疾病严重程度相关（<0.001），与合并症的数量和严重程度相关（<0.001）。此外，mSCOPE与机械通气天数（<0.001）和ICU住院天数显著相关（=0.003）。mSCOPE被发现是死亡率的独立预测指标（风险比：1.219，95%置信区间：1.010-1.471，=0.039），mSCOPE值≥6预测预后不良，其敏感度（95%置信区间）为88.6%，特异度为29.7%，阳性预测值为31.5%，阴性预测值为87.7%。
结论
mSCOPE评分在患者风险分层中可能有用，可为重症COVID-19患者的临床干预提供指导。
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