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基于炎症的预后风险评分对COVID-19患者住院死亡风险的预测评估:一项横断面回顾性研究

Evaluation of Inflammation-Based Prognostic Risk Scores in Predicting in-Hospital Mortality Risk in COVID-19 Patients: A Cross-Sectional Retrospective Study.

作者信息

Çelik Çaşıt Olgun, Özer Nurtaç, Çiftci Orçun, Torun Şerife, Çolak Meriç Yavuz, Müderrisoğlu İbrahim Haldun

机构信息

Department of Cardiology, Başkent University Konya Practise and Research Hospital, Konya, Turkey.

Department of Cardiology, Private Natomed Hospital, Ankara, Turkey.

出版信息

Infect Dis Clin Microbiol. 2023 Mar 11;5(1):4-12. doi: 10.36519/idcm.2023.171. eCollection 2023 Mar.

Abstract

OBJECTIVE

Systemic inflammatory parameters are predictors of poor prognosis in COVID-19 patients. This study evaluated whether the prognostic nutritional index, which was also related to nutrition risk and other inflammation-based prognostic scores, was predictive of in-hospital mortality in COVID-19 patients.

MATERIALS AND METHODS

This was a retrospective cross-sectional single-center study. Based on the exclusion criteria, 151 patients over 18 years old diagnosed with COVID-19 and hospitalized in the intensive care unit between March 2020 and December 2020 were eligible for this study. Multivariable logistic regression analysis was performed to evaluate the predictive value of the Glasgow Prognostic Score (GPS), Prognostic Index (PI), Prognostic Nutritional Index (PNI), and Systemic Inflammatory Index (SII).

RESULTS

In the univariate analyses, age, diabetes mellitus (DM), chronic kidney disease, acute kidney injury, hypothyroidism, hospitalization stay, lactate dehydrogenase (LDH), aspartate aminotransferase (AST), D-dimer, ferritin, C-reactive protein (CRP), albumin, hemoglobin level, platelet count, urea, creatinine level, PNI, GPS were significantly associated with mortality. However, in the multivariable logistic regression analysis of the inflammation-based prognostic scores, only PNI was statistically significant in predicting in-hospital mortality (OR=0.83; [95% CI=0.71-0.97]; =0.019).

CONCLUSION

PNI is a more useful and powerful tool among these inflammation-based prognostic risk scores in predicting in-hospital mortality in COVID-19 patients.

摘要

目的

全身炎症参数是新冠病毒疾病(COVID-19)患者预后不良的预测指标。本研究评估了同样与营养风险及其他基于炎症的预后评分相关的预后营养指数,是否可预测COVID-19患者的院内死亡率。

材料与方法

这是一项回顾性横断面单中心研究。根据排除标准,2020年3月至2020年12月期间,151例年龄在18岁以上、确诊为COVID-19并入住重症监护病房的患者符合本研究条件。进行多变量逻辑回归分析,以评估格拉斯哥预后评分(GPS)、预后指数(PI)、预后营养指数(PNI)和全身炎症指数(SII)的预测价值。

结果

在单变量分析中,年龄、糖尿病(DM)、慢性肾脏病、急性肾损伤、甲状腺功能减退、住院时间、乳酸脱氢酶(LDH)、天冬氨酸转氨酶(AST)、D-二聚体、铁蛋白、C反应蛋白(CRP)、白蛋白、血红蛋白水平、血小板计数、尿素、肌酐水平、PNI、GPS与死亡率显著相关。然而,在基于炎症的预后评分的多变量逻辑回归分析中,只有PNI在预测院内死亡率方面具有统计学意义(OR=0.83;[95%CI=0.71-0.97];P=0.019)。

结论

在这些基于炎症的预后风险评分中,PNI是预测COVID-19患者院内死亡率更有用且更有效的工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e5a/10986716/a62bd9a5353a/IDCM-5-1-171_Figure1.jpg

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