Department of Tuberculosis and Respiratory Pathology, Military Hospital 175, Ho Chi Minh City, Vietnam.
Military Hospital 175, Ho Chi Minh City, Vietnam.
BMC Pulm Med. 2024 Jan 10;24(1):24. doi: 10.1186/s12890-023-02838-1.
Despite global efforts to control the COVID-19 pandemic, the emergence of new viral strains continues to pose a significant threat. Accurate patient stratification, optimized resource allocation, and appropriate treatment are crucial in managing COVID-19 cases. To address this, a simple and accurate prognostic tool capable of rapidly identifying individuals at high risk of mortality is urgently needed. Early prognosis facilitates predicting treatment outcomes and enables effective patient management. The aim of this study was to develop an early predictive model for assessing mortality risk in hospitalized COVID-19 patients, utilizing baseline clinical factors.
We conducted a descriptive cross-sectional study involving a cohort of 375 COVID-19 patients admitted and treated at the COVID-19 Patient Treatment Center in Military Hospital 175 from October 2021 to December 2022.
Among the 375 patients, 246 and 129 patients were categorized into the survival and mortality groups, respectively. Our findings revealed six clinical factors that demonstrated independent predictive value for mortality in COVID-19 patients. These factors included age greater than 50 years, presence of multiple underlying diseases, dyspnea, acute confusion, saturation of peripheral oxygen below 94%, and oxygen demand exceeding 5 L per minute. We integrated these factors to develop the Military Hospital 175 scale (MH175), a prognostic scale demonstrating significant discriminatory ability with an area under the curve (AUC) of 0.87. The optimal cutoff value for predicting mortality risk using the MH175 score was determined to be ≥ 3 points, resulting in a sensitivity of 96.1%, specificity of 63.4%, positive predictive value of 58%, and negative predictive value of 96.9%.
The MH175 scale demonstrated a robust predictive capacity for assessing mortality risk in patients with COVID-19. Implementation of the MH175 scale in clinical settings can aid in patient stratification and facilitate the application of appropriate treatment strategies, ultimately reducing the risk of death. Therefore, the utilization of the MH175 scale holds significant potential to improve clinical outcomes in COVID-19 patients.
An independent ethics committee approved the study (Research Ethics Committee of Military Hospital 175 (No. 3598GCN-HDDD; date: October 8, 2021), which was performed in accordance with the Declaration of Helsinki, Guidelines for Good Clinical Practice.
尽管全球努力控制 COVID-19 大流行，但新病毒株的出现仍持续构成重大威胁。对 COVID-19 病例进行准确的患者分层、优化资源配置和适当的治疗至关重要。为此，我们迫切需要一种简单且准确的预后工具，以便能够快速识别出具有高死亡风险的个体。早期预后有助于预测治疗结局并实现有效的患者管理。本研究旨在开发一种基于基线临床因素评估住院 COVID-19 患者死亡风险的早期预测模型。
我们进行了一项描述性的横断面研究，纳入了 2021 年 10 月至 2022 年 12 月在军事医院 175 号的 COVID-19 患者治疗中心收治和治疗的 375 例 COVID-19 患者。
在 375 例患者中，246 例和 129 例患者分别归入生存组和死亡组。我们的研究结果显示，6 个临床因素对 COVID-19 患者的死亡率具有独立的预测价值。这些因素包括年龄大于 50 岁、存在多种基础疾病、呼吸困难、急性意识混乱、外周血氧饱和度低于 94%以及氧需求超过 5L/分钟。我们整合了这些因素，制定了军事医院 175 号量表（MH175），该量表具有显著的鉴别能力，曲线下面积（AUC）为 0.87。使用 MH175 评分预测死亡率风险的最佳截断值被确定为≥3 分，此时其预测死亡率风险的敏感性为 96.1%，特异性为 63.4%，阳性预测值为 58%，阴性预测值为 96.9%。
MH175 量表在评估 COVID-19 患者的死亡风险方面具有强大的预测能力。在临床实践中实施 MH175 量表可以帮助对患者进行分层，并有助于应用适当的治疗策略，从而降低死亡风险。因此，使用 MH175 量表具有改善 COVID-19 患者临床结局的巨大潜力。
独立伦理委员会批准了该研究（军事医院 175 号研究伦理委员会（编号 3598GCN-HDDD；日期：2021 年 10 月 8 日），该研究符合《赫尔辛基宣言》和《良好临床实践指南》的规定。
