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新型冠状病毒肺炎机械通气患者早期死亡的sICOP评分的外部验证

External validation of the sICOP score for early mortality in mechanically ventilated patients with COVID-19.

作者信息

Nishikimi Mitsuaki, Hayashida Kei, Tagami Takashi, Ohshimo Shinichiro, Shime Nobuaki, Yamakawa Kazuma

机构信息

Department of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences Hiroshima University Hiroshima Japan.

Department of Emergency and Critical Care Medicine Nagoya University Graduate School of Medicine Nagoya Japan.

出版信息

Acute Med Surg. 2024 Dec 9;11(1):e978. doi: 10.1002/ams2.978. eCollection 2024 Jan-Dec.

Abstract

BACKGROUND AND OBJECTIVES

The aim of this study was to externally validate the prognostic score for mechanically ventilated patients with novel coronavirus disease-2019 (COVID-19), the simplified intubated COVID-19 predictive (sICOP) score.

METHODS

This was a retrospective, multicenter, observational study conducted using the database registry of patients with moderate-to-severe COVID-19 at 66 hospitals in Japan. The data of 146 mechanically ventilated COVID-19 patients were analyzed.

RESULTS

The areas under the curve (AUC) of the sICOP score for predicting the 28-day mortality and in-hospital mortality were 0.81 (0.73-0.89) and 0.74 (0.65-0.83), respectively. The AUC of the score was statistically significantly higher than that of the SOFA score for 28-day mortality and in-hospital mortality (28-day mortality; 0.82 [0.73-0.90] vs. 0.58 [0.46-0.70],  < 0.001, in-hospital mortality; 0.75 [0.66-0.84] vs 0.55 [0.44-0.66],  < 0.001).

CONCLUSION

We found that the sICOP score was useful for predicting the 28-day mortality with excellent accuracy in mechanically ventilated COVID-19 patients in the era prior to the widespread availability of vaccines and effective antivirals. Validation of the score would be needed by using data from recent waves.

摘要

背景与目的

本研究旨在对外验证新型冠状病毒病2019(COVID-19)机械通气患者的预后评分,即简化插管COVID-19预测(sICOP)评分。

方法

这是一项回顾性、多中心、观察性研究,使用了日本66家医院中重度COVID-19患者的数据库登记资料。对146例机械通气的COVID-19患者的数据进行了分析。

结果

sICOP评分预测28天死亡率和院内死亡率的曲线下面积(AUC)分别为0.81(0.73 - 0.89)和0.74(0.65 - 0.83)。该评分的AUC在预测28天死亡率和院内死亡率方面显著高于序贯器官衰竭评估(SOFA)评分(28天死亡率:0.82 [0.73 - 0.90] 对 0.58 [0.46 - 0.70],P < 0.001;院内死亡率:0.75 [0.66 - 0.84] 对 0.55 [0.44 - 0.66],P < 0.001)。

结论

我们发现,在疫苗和有效抗病毒药物广泛应用之前的时代,sICOP评分在预测机械通气COVID-19患者的28天死亡率方面具有很高的准确性,非常有用。需要使用近期疫情的数据对该评分进行验证。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bd5b/11628425/e708eb2d726d/AMS2-11-e978-g002.jpg

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