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在波兰使用早期预警评分预测急诊科收治的COVID-19患者的死亡率。

Predicting Mortality for COVID-19 Patients Admitted to an Emergency Department Using Early Warning Scores in Poland.

作者信息

Rzońca Patryk, Butkiewicz Sławomir, Dobosz Paula, Zaczyński Artur, Podgórski Marcin, Gałązkowski Robert, Wierzba Waldemar, Życińska Katarzyna

机构信息

Department of Human Anatomy, Faculty of Health Sciences, Medical University of Warsaw, 02-091 Warsaw, Poland.

Emergency Department, The National Institute of Medicine of the Ministry of Interior and Administration, 02-507 Warsaw, Poland.

出版信息

Healthcare (Basel). 2024 Mar 19;12(6):687. doi: 10.3390/healthcare12060687.

Abstract

COVID-19 disease is characterised by a wide range of symptoms that in most cases resemble flu or cold. Early detection of infections, monitoring of patients' conditions, and identification of patients with worsening symptoms became crucial during the peak of pandemic. The aim of this study was to assess and compare the performance of common early warning scores at the time of admission to an emergency department in predicting in-hospital mortality in patients with COVID-19. The study was based on a retrospective analysis of patients with SARS-CoV-2 infection admitted to an emergency department between March 2020 and April 2022. The prognostic value of early warning scores in predicting in-hospital mortality was assessed using the receiver operating characteristic (ROC) curve. Patients' median age was 59 years, and 52.33% were male. Among all the EWS we assessed, REMS had the highest overall accuracy (AUC 0.84 (0.83-0.85)) and the highest NPV (97.4%). REMS was the most accurate scoring system, characterised by the highest discriminative power and negative predictive value compared to the other analysed scoring systems. Incorporating these tools into clinical practice in a hospital emergency department could provide more effective assessment of mortality and, consequently, avoid delayed medical assistance.

摘要

新冠病毒病的症状多种多样,在大多数情况下类似于流感或感冒。在疫情高峰期,早期发现感染、监测患者病情以及识别症状恶化的患者变得至关重要。本研究的目的是评估和比较急诊科收治时常见预警评分在预测新冠病毒病患者院内死亡率方面的表现。该研究基于对2020年3月至2022年4月期间急诊科收治的严重急性呼吸综合征冠状病毒2感染患者的回顾性分析。使用受试者工作特征(ROC)曲线评估预警评分在预测院内死亡率方面的预后价值。患者的中位年龄为59岁,52.33%为男性。在我们评估的所有早期预警系统(EWS)中,快速急诊医学评分(REMS)具有最高的总体准确性(曲线下面积[AUC]为0.84[0.83 - 0.85])和最高的阴性预测值(97.4%)。与其他分析的评分系统相比,REMS是最准确的评分系统,具有最高的判别力和阴性预测值。将这些工具纳入医院急诊科的临床实践可以更有效地评估死亡率,从而避免医疗救助延迟。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/37ff/10970280/c16599b4dd8d/healthcare-12-00687-g001.jpg

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