在因SARS-CoV-2感染住院的重症患者中开发抗凝药的决策支持工具:CALT协议
Victoria Dubar1, Tiffany Pascreau2,3, Annabelle Dupont4
1CHU Lille, Pôle de Médecine Intensive-Réanimation, F-59000 Lille, France.
Biomedicines
|June 28, 2023
概括
新的得分预测严重的COVID-19患者的血栓栓塞事件 (TEE). 使用D-二聚合物,费里丁,纤维素和LDH的CALT评分为ICU患者提供了可靠的风险评估,有助于做出抗凝决定.
科学领域:
- 关键护理医学 关键护理医学
- 血液学 血液学 血液学
- 传染性疾病 传染性疾病
背景情况:
- 严重的COVID-19与高血栓栓塞事件 (TEE) 的高风险有关.
- 在严重的COVID-19患者中预测TEE风险是具有挑战性的,因为在住院期间的标准测试不可靠.
- 在重症监护室 (ICU) 设置中确定TEE的特定风险因素至关重要.
研究的目的:
- 为了确定在ICU入院和ICU停留期间严重的SARS-CoV-2感染中TEE的特定风险因素.
- 开发和评估复合得分,以预测在ICU入院后的前48小时 (H0-H48) 和前15天 (D1-D15) 内的严重COVID-19患者的TEE.
主要方法:
- 在两个中心对124名严重的COVID-19患者进行了回顾性分析.
- 使用逐步回归来创建基于实验室值的两个复合得分 (CALT 1和CALT 2).
- 采用接收器操作特征 (ROC) 分析来评估开发的得分的诊断性能 (曲线下的面积 - AUC).
主要成果:
- 患有TEE的患者表现出较高的D-二聚合物和费里丁水平,并在1日至3天之间纤维素原的下降更大.
- 在第1天计算的CALT 1得分在预测H0-H48范围内的TEE方面表现强 (AUC = 0.85).
- 在第3天计算的CALT 2得分有效预测了D1-D15内的TEE (AUC = 0.85).
结论:
- 开发的CALT得分在预测严重COVID-19患者TEE风险方面表现良好.
- 这些评分可以作为一个决策支持工具,用于启动ICU患者的治疗抗凝药.
- 在严重的SARS-CoV-2感染期间,CALT协议为管理抗凝血策略提供了宝贵的帮助.
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