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验证巴氏指数作为新冠病毒肺炎患者院内死亡率预测指标的有效性

Validation of the Barthel Index as a Predictor of In-Hospital Mortality among COVID-19 Patients.

作者信息

Mateos-Arroyo Julio Alberto, Zaragoza-García Ignacio, Sánchez-Gómez Rubén, Posada-Moreno Paloma, Ortuño-Soriano Ismael

机构信息

Department of Pneumology, Hospital General Nuestra Señora del Prado, 45600 Talavera de la Reina, Spain.

Department of Nursing, Faculty of Nursing, Physiotherapy and Podology, University Complutense of Madrid, 28040 Madrid, Spain.

出版信息

Healthcare (Basel). 2023 May 6;11(9):1338. doi: 10.3390/healthcare11091338.

Abstract

In order to predict the high mortality due to COVID-19, simple, useful and remote instruments are required. To assess the validity of the baseline Barthel Index score as a predictor of in-hospital mortality among COVID-19 patients, a validation study of a clinical prediction tool in a cohort of patients with COVID-19 was conducted. The primary variable was mortality and the Barthel Index was the main explanatory variable. Demographic, clinical and laboratory variables were collected. Other mortality predictor scores were also assessed: Pneumonia Severity Index, CURB-65 and A-DROP. The Receiver Operating Characteristic Area under the Curve (ROC AUC), sensitivity and specificity were calculated for both the Barthel Index and the other predictor scores. An analysis of the association between the main variables was conducted, adjusting by means of three multivariate models. Three hundred and twelve patients were studied. Mortality was 16.4%. A mortality Odds Ratio (OR) of 5.95 was associated with patients with a Barthel Index ≤ 90. The model number 3 was developed to predict in-hospital mortality before COVID-19 infection occurs. It exhibits an OR of 3.44, a ROC AUC of 0.792, a sensitivity of 74.5% and a specificity of 73.9%. The Baseline Barthel Index proved useful in our population as a predictor of in-hospital mortality due to COVID-19.

摘要

为预测新型冠状病毒肺炎(COVID-19)导致的高死亡率,需要简单、实用且可远程操作的工具。为评估基线巴氏指数评分作为COVID-19患者院内死亡率预测指标的有效性,对一组COVID-19患者进行了一项临床预测工具的验证研究。主要变量是死亡率,巴氏指数是主要解释变量。收集了人口统计学、临床和实验室变量。还评估了其他死亡率预测评分:肺炎严重程度指数、CURB-65和A-DROP。计算了巴氏指数和其他预测评分的曲线下面积(ROC AUC)、敏感性和特异性。通过三个多变量模型对主要变量之间的关联进行了分析。共研究了312例患者。死亡率为16.4%。巴氏指数≤90的患者死亡率比值比(OR)为5.95。开发了模型3来预测COVID-19感染发生前的院内死亡率。其OR为3.44,ROC AUC为0.792,敏感性为74.5%,特异性为73.9%。基线巴氏指数在我们的研究人群中被证明是预测COVID-19导致的院内死亡率的有用指标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6973/10178780/db1649b3b217/healthcare-11-01338-g001.jpg

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