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Predicting Mechanical Ventilation, Intensive Care Unit Admission, and Mortality in COVID-19 Patients: Comparison of Seven Different Scoring Systems
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Predicting Mechanical Ventilation, Intensive Care Unit Admission, and Mortality in COVID-19 Patients: Comparison of Seven Different Scoring Systems
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Journal Article
Predicting Mechanical Ventilation, Intensive Care Unit Admission, and Mortality in COVID-19 Patients: Comparison of Seven Different Scoring Systems
2024
Overview
ÖZ Amaç Çalışmada skorlama sistemlerinin koronavirüs hastalığı-2019 (COVİD-19) şiddetini belirleyip belirlemediğini araştırdık. Gereç ve Yöntem 01.09.2020 ve 31.04.2021 tarihleri arasında yatan COVİD-19 hastaları retrospektif olarak incelendi. Başvuru günündeki ulusal erken uyarı skoru (NEWS), modifiye erken uyarı skoru, hızlı acil tıp skoru, tekrarlanan-sepsis ilişkili organ yetmezliği hızlı değerlendirmesi skoru (q-SOFA), CURB-65, MuLBSTA ve ISARIC 4C skorları hesaplandı. Skorlama sistemlerinin mekanik ventilasyon (MV) ihtiyacını, yoğun bakım ünitesine (YBÜ) yatışını ve 30 günlük mortaliteyi öngörme kapasitesi incelendi. Bulgular Toplam 292 hasta dahil edildi, 137’si (%46,9) kadındı, yaş ortalaması 62,5±15,4 yıldı. Hastaların 69’unun (%23,6) YBÜ yatışı gerekti, 45 (%15,4) hastada MV’ye ihtiyaç duyuldu ve 49 (%16,8) hasta 30 gün içinde öldü. Q-SOFA ile MV ihtiyacı arasında bir ilişki bulunmadı (p=0,167) ancak diğer tüm skorlama sistemleri ile MV ihtiyacı, YBÜ yatış ve 30 günlük mortalite arasında istatistiksel olarak anlamlı bir ilişki bulundu (p5,5) ve NEWS (optimal cut-off >3,5) iken en düşük q-SOFA idi. Sonuç İlk başvurularında ISARIC-4C ve NEWS başta olmak üzere mevcut skorlama sistemleri kullanılarak COVİD-19’un şiddeti tahmin edilebilecektir. Böylece gerekli müdahalelerin daha erken yapılarak mortalite ve morbiditenin azaltılabilecektir. Objective: In this study, we investigated whether scoring systems determine COVID- 19 severity. Materials and Methods: COVID-19 patients hospitalized between 01.09.2020 and 31.04.2021 were retrospectively assessed. The National Early Warning Score (NEWS), Modified Early Warning Score (MEWS), Rapid Emergency Medicine Score (REMS), Quick Sequential Organ Failure Assessment Score (q-SOFA), CURB-65, MuLBSTA, and ISARIC 4C scores on admission day were calculated. Scoring systems’ ability to predict mechanical ventilation (MV) need, intensive care unit (ICU) admission, and 30-day mortality were assessed. Results: A total of 292 patients were included; 137 (46.9%) were female, and the mean age was 62.5±15.4 years. 69 (23.6%) patients required ICU admission, 45 (15.4%) needed MV, and 49 (16.8%) died within 30 days. No relationship was found between qSOFA and MV need (p=0.167), but a statistically significant relationship was found between other scoring systems and MV need, ICU admission, and 30-day mortality (p5.5) and NEWS (optimal cut-off >3.5) had the highest area under the curve in ROC curve analyses, whereas qSOFA had the lowest. Conclusion: The severity of COVID-19 could be estimated by using these scoring systems, especially ISARIC-4C and NEWS, at the first admission. Thus, mortality and morbidity would be reduced by making the necessary interventions earlier.
Publisher
Galenos Publishing House
Subject
