COVID-19:南非预测评分系统的评估
Brent Tyler Aloysius Prim1, Ismail Sikander Kalla2, Jarrod Zamparini1
1Department of Internal Medicine, University of Witwatersrand, Johannesburg, 2193, South Africa.
Heliyon
|November 29, 2023
概括
NEWS2和ISARIC-4C得分有效预测COVID-19患者的死亡率. 在南非情况下,CURB65得分显示出局限性,原因是低风险组中无法解释的风险因素.
科学领域:
- 关键护理医学 关键护理医学
- 传染性疾病 传染性疾病
- 公共卫生 公共卫生
背景情况:
- 由SARS-CoV-2引起的COVID-19大流行已经导致全球超过7亿例病例.
- 像CURB65,NEWS2和ISARIC-4C这样的严重性得分对于评估COVID-19患者的结果至关重要.
- 有效的风险分层有助于医疗保健工作者在患者分拣和护理分配方面.
研究的目的:
- 评估CURB65,NEWS2和ISARIC-4C死亡率评分对于住院COVID-19患者的关键结果的预测效用.
- 在入院时使用临床特征来评估这些分数的表现.
- 确定与死亡率和其他关键结果相关的风险因素.
主要方法:
- 一项回顾性队列研究,涉及南非605名中度至重度COVID-19的成年患者.
- 分析住院死亡率,侵入性机械通风和ICU入院作为关键结果.
- 根据接收机运营商特征 (AUROC) 分析和后勤回归来评估得分性能.
主要成果:
- NEWS2和ISARIC-4C评分在预测住院死亡率方面表现良好 (AUROC~0.77).
- 在CURB65,ISARIC-4C和NEWS2分数中,中度和重度风险组的死亡率更高.
- NEWS2获得了92.2%的灵敏度,死亡率为8.6%;ISARIC-4C具有87.6%的灵敏度,死亡率为8%.
结论:
- NEWS2和ISARIC-4C分数是预测南非中度至重度COVID-19患者死亡率的宝贵工具.
- CURB65评分的实用性受到其低风险组中高死亡率的限制,这表明未计入的风险因素.
- 需要进一步的研究来确定在这种环境中改善COVID-19患者管理的额外风险因素.
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