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急诊科收治的COVID-19患者风险分层中胸部计算机断层扫描评分与实验室生物标志物之间的相关性

Correlation between Chest Computed Tomography Score and Laboratory Biomarkers in the Risk Stratification of COVID-19 Patients Admitted to the Emergency Department.

作者信息

D'Agostini Cartesio, Legramante Jacopo M, Minieri Marilena, Di Lecce Vito N, Lia Maria Stella, Maurici Massimo, Simonelli Ilaria, Ciotti Marco, Paganelli Carla, Terrinoni Alessandro, Giovannelli Alfredo, Pieri Massimo, Gallù Mariacarla, Dell'Olio Vito, Prezioso Carla, Limongi Dolores, Bernardini Sergio, Orlacchio Antonio

机构信息

Department of Experimental Medicine, University of Rome Tor Vergata, 00133 Rome, Italy.

Laboratory of Microbiology, Polyclinic of "Tor Vergata", 00133 Rome, Italy.

出版信息

Diagnostics (Basel). 2023 Aug 31;13(17):2829. doi: 10.3390/diagnostics13172829.

Abstract

BACKGROUND

It has been reported that mid-regional proadrenomedullin (MR-proADM) could be considered a useful tool to stratify the mortality risk in COVID-19 patients upon admission to the emergency department (ED). During the COVID-19 outbreak, computed tomography (CT) scans were widely used for their excellent sensitivity in diagnosing pneumonia associated with SARS-CoV-2 infection. However, the possible role of CT score in the risk stratification of COVID-19 patients upon admission to the ED is still unclear.

AIM

The main objective of this study was to assess if the association of the CT findings alone or together with MR-proADM results could ameliorate the prediction of in-hospital mortality of COVID-19 patients at the triage. Moreover, the hypothesis that CT score and MR-proADM levels together could play a key role in predicting the correct clinical setting for these patients was also evaluated.

METHODS

Epidemiological, demographic, clinical, laboratory, and outcome data were assessed and analyzed from 265 consecutive patients admitted to the triage of the ED with a SARS-CoV-2 infection.

RESULTS AND CONCLUSIONS

The accuracy results by AUROC analysis and statistical analysis demonstrated that CT score is particularly effective, when utilized together with the MR-proADM level, in the risk stratification of COVID-19 patients admitted to the ED, thus helping the decision-making process of emergency physicians and optimizing the hospital resources.

摘要

背景

据报道,中段肾上腺髓质素原(MR-proADM)可被视为对急诊科(ED)收治的新冠肺炎患者进行死亡风险分层的有用工具。在新冠疫情期间,计算机断层扫描(CT)因其在诊断与SARS-CoV-2感染相关肺炎方面的出色敏感性而被广泛使用。然而,CT评分在ED收治的新冠肺炎患者风险分层中的潜在作用仍不明确。

目的

本研究的主要目的是评估单独的CT检查结果或与MR-proADM结果相结合是否能改善对分诊时新冠肺炎患者院内死亡的预测。此外,还评估了CT评分和MR-proADM水平共同作用在预测这些患者正确临床情况方面可能发挥关键作用的假设。

方法

对265例因SARS-CoV-2感染在ED分诊处收治的连续患者的流行病学、人口统计学、临床、实验室及预后数据进行评估和分析。

结果与结论

AUROC分析和统计分析的准确性结果表明,CT评分与MR-proADM水平一起使用时,在对ED收治的新冠肺炎患者进行风险分层方面特别有效,从而有助于急诊医生的决策过程并优化医院资源。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eda8/10486389/854caf589871/diagnostics-13-02829-g001.jpg

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