Comparison of Prognostic Scores for Patients with COVID-19 Presenting with Dyspnea in the Emergency Department

被引:4
|
作者
Yang, Shuai [1 ]
Zhang, Yuxin [2 ]
He, Yan [1 ,4 ]
Liu, Shengming [3 ,5 ]
机构
[1] Jinan Univ, Zhuhai Peoples Hosp, Dept Emergency Intens Care Unit, Zhuhai Hosp, Zhuhai, Peoples R China
[2] Jinan Univ, Zhuhai Peoples Hosp, Dept Gastroenterol, Zhuhai Hosp, Zhuhai, Peoples R China
[3] Jinan Univ, Dept Pulm & Crit Care Med, Affiliated Hosp 1, Guangzhou, Peoples R China
[4] Jinan Univ, Dept Emergency Intens Care Unit, Zhuhai Hosp, 79 Kangning Rd, Zhuhai 519000, Peoples R China
[5] Jinan Univ, Affiliated Hosp 1, Dept Pulm & Crit Care Med, 613 W Huangpu Ave, Guangzhou 510630, Peoples R China
来源
JOURNAL OF EMERGENCY MEDICINE | 2023年 / 65卷 / 06期
关键词
COVID-19; SpO2/FiO2; ROX; NEWS; qSOFA; CRB-65; emergency department; FLOW NASAL CANNULA; HYPOXEMIC RESPIRATORY-FAILURE; ROX INDEX; SPO(2)/FIO2; PAO2/FIO2; OUTCOMES;
D O I
10.1016/j.jemermed.2023.07.013
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Background: Easy-to-use bedside risk assessment is crucial for patients with COVID-19 in the overcrowded emergency department (ED).Objective: The aim of this study was to explore the prognostic ability of ratio of percutaneous oxygen saturation (SpO(2)) to fraction of inspired oxygen (FiO(2)) (S/F); ratio of SpO(2)/FiO(2) to respiratory rate (ROX); National Early Warning Score (NEWS); quick Sequential Organ Failure Assessment (qSOFA); and confusion, respiratory rate, blood pressure, and age >= 65 years (CRB-65) in patients with COVID-19 presenting with dyspnea to the ED.Methods: In this retrospective observational study, clinical and demographic details of patients with COVID-19 were obtained at ED admission. S/F, ROX, NEWS, CRB-65, and qSOFA scores were calculated at the time of ED arrival. Accuracy of these five indices to predict the need for invasive mechanical ventilation (IMV) within 48 h, intensive care unit (ICU) admission, and early (7-day) mortality were determined using receiver operating characteristic curves.Results: A total of 375 patients were included in this study. Fifty patients (13.3%) required IMV within 48 h and 58 patients (15.5%) were transferred to the ICU. Seven-day mortality was 6.7% and 28-day mortality was 18.1%. Among all five scores determined from patient data on ED admission, ROX, S/F, and NEWS presented greater discriminatory performance than CRB-65 and qSOFA in predicting IMV within 48 h, ICU admission, and early mortality.Conclusions: Emergency physicians can effectively use S/F, ROX, and NEWS scores for rapid risk stratification of patients with COVID-19 infection. Moreover, from the perspective of simplicity and ease of calculation, we recommend the use of the S/F ratio.
引用
收藏
页码:E487 / E494
页数:8
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