Tanase Alina Doina, Petrescu Emanuela-Lidia, Hoinoiu Teodora, Bojoga Daliana-Emanuela, Timar Bogdan
Department of Professional Legislation in Dental Medicine, Faculty of Dental Medicine, "Victor Babes" University of Medicine and Pharmacy, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania.
Doctoral School, "Victor Babes" University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania.
Biomedicines. 2024 Oct 31;12(11):2495. doi: 10.3390/biomedicines12112495.
The COVID-19 pandemic has necessitated the development of reliable prognostic tools to predict patient outcomes and guide clinical decisions. This study evaluates the predictive utility of several clinical scores-PAINT, ISARIC4C, CHIS, COVID-GRAM, SOFA, and CURB-65-for in-hospital mortality among COVID-19 patients, comparing their effectiveness at admission and seven days post-symptom onset.
In this retrospective cohort study conducted at the Clinical Emergency Hospital Pius Brînzeu in Timișoara, adult patients hospitalized with confirmed SARS-CoV-2 infection were included. The study was approved by the Local Ethics Committee, adhering to GDPR and other regulatory standards. Prognostic scores were calculated using patient data at admission and Day 7. Statistical analyses included ROC curves, Kaplan-Meier survival analysis, and multivariate Cox regression.
The study comprised 269 patients, with a notable distinction in outcomes between survivors and non-survivors. Non-survivors were older (mean age 62.12 years) and exhibited higher comorbidity rates, such as diabetes (55.56% vs. 31.06%) and cardiovascular diseases (48.15% vs. 29.81%). Prognostic scores were significantly higher among non-survivors at both time points, with PAINT and ISARIC4C showing particularly strong predictive performances. The AUROC for PAINT increased from 0.759 at admission to 0.811 by Day 7, while ISARIC4C demonstrated an AUROC of 0.776 at admission and 0.798 by Day 7. Multivariate Cox regression indicated that a PAINT score above 8.10 by Day 7 was associated with a hazard ratio (HR) of 4.9 (95% CI: 3.12-7.72) for mortality.
The study confirms the strong predictive value of the PAINT, ISARIC4C, CHIS, COVID-GRAM, SOFA, and CURB-65 scores in determining mortality risk among hospitalized COVID-19 patients. These scores can significantly aid clinicians in early-risk stratification and resource prioritization, potentially enhancing patient management and outcomes in acute care settings.
新冠疫情使得开发可靠的预后工具以预测患者预后并指导临床决策成为必要。本研究评估了几种临床评分系统——PAINT、ISARIC4C、CHIS、COVID - GRAM、SOFA和CURB - 65——对新冠患者院内死亡率的预测效用，比较它们在入院时及症状出现后7天的有效性。
在蒂米什瓦拉的皮乌斯·布林泽乌临床急诊医院进行的这项回顾性队列研究中，纳入了确诊感染SARS-CoV-2的成年住院患者。该研究经当地伦理委员会批准，遵循通用数据保护条例（GDPR）和其他监管标准。使用入院时和第7天的患者数据计算预后评分。统计分析包括ROC曲线、Kaplan-Meier生存分析和多变量Cox回归。
该研究共纳入269例患者，幸存者和非幸存者的预后有显著差异。非幸存者年龄较大（平均年龄62.12岁），合并症发生率较高，如糖尿病（55.56%对31.06%）和心血管疾病（48.15%对29.81%）。在两个时间点，非幸存者的预后评分均显著更高，PAINT和ISARIC4C显示出特别强的预测性能。PAINT的曲线下面积（AUROC）从入院时的0.759增加到第7天的0.811，而ISARIC4C在入院时的AUROC为0.776，第7天为0.798。多变量Cox回归表明，到第7天时PAINT评分高于8.10与死亡风险比（HR）为4.9（95%置信区间：3.12 - 7.72）相关。
该研究证实了PAINT、ISARIC4C、CHIS、COVID - GRAM、SOFA和CURB - 65评分在确定住院新冠患者死亡风险方面具有很强的预测价值。这些评分可显著帮助临床医生进行早期风险分层和资源优先级排序，有可能改善急性护理环境中的患者管理和预后。
