Dataset Information

[C-Reactive protein and SOFA scale: A simple score as early predictor of critical care requirement in patients with COVID-19 pneumonia in Spain].

ABSTRACT:

Objective

To identify potential markers at admission predicting the need for critical care in patients with COVID-19 pneumonia.

Material and methods

An approved, observational, retrospective study was conducted between March 15 to April 15, 2020. 150 adult patients aged less than 75 with Charlson comorbidity index ≤ 6 diagnosed with COVID-19 pneumonia were included. Seventy-five patients were randomly selected from those admitted to the critical care units (critical care group [CG]) and seventy-five hospitalized patients who did not require critical care (non-critical care group [nCG]) represent the control group. One additional cohort of hospitalized patients with COVID-19 were used to validate the score.

Measurements and main results

Multivariable regression showed increasing odds of in-hospital critical care associated with increased C-reactive protein (CRP) (odds ratio 1.052 [1.009-1.101]; P = .0043) and higher Sequential Organ Failure Assessment (SOFA) score (1.968 [1.389-2.590]; P < .0001), both at the time of hospital admission. The AUC-ROC for the combined model was 0.83 (0.76-0.90) (vs AUC-ROC SOFA P < .05). The AUC-ROC for the validation cohort was 0.89 (0.82-0.95) (P > 0.05 vs AUC-ROC development).

Conclusion

Patients COVID-19 presenting at admission SOFA score ≥ 2 combined with CRP ≥ 9,1 mg/mL could be at high risk to require critical care.

SUBMITTER: Vaquero-Roncero LM

PROVIDER: S-EPMC7833846 | biostudies-literature | 2021 Nov

REPOSITORIES: biostudies-literature

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Publications

[C-Reactive protein and SOFA scale: A simple score as early predictor of critical care requirement in patients with COVID-19 pneumonia in Spain].

Vaquero-Roncero L M LM Sánchez-Barrado E E Escobar-Macias D D Arribas-Pérez P P González de Castro R R González-Porras J R JR Sánchez-Hernandez M V MV

Revista espanola de anestesiologia y reanimacion 20210116 9

<h4>Objective</h4>To identify potential markers at admission predicting the need for critical care in patients with COVID-19 pneumonia.<h4>Material and methods</h4>An approved, observational, retrospective study was conducted between March 15 to April 15, 2020. 150 adult patients aged less than 75 with Charlson comorbidity index ≤ 6 diagnosed with COVID-19 pneumonia were included. Seventy-five patients were randomly selected from those admitted to the critical care units (critical care group [CG ...[more]

PMID: 33994585

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Project description:Abstract Background and Aim The efficacy of Sequential Organ Failure Assessment (SOFA) score as predictor of clinical outcomes among ICU‐admitted COVID‐19 patients is still controversial. We aimed to assess whether SOFA‐score in different time intervals could predict 28‐day mortality compared with other well‐acknowledged risk factors of COVID‐19 mortality. Methods This observational prospective cohort was conducted on 1057 patients from March 2020 to March 2022 at Masih Daneshvari Hospital, Iran. The univariate and multivariate Cox proportional analysis were performed to assess the hazards of SOFA‐score models. Receiver operating characteristic (ROC) curves were designed to estimate the predictive values. Results Mean SOFA‐score during first 96 h (HR: 3.82 [CI: 2.75–5.31]), highest SOFA‐score (HR: 2.70 [CI: 1.93–3.78]), and initial SOFA‐score (HR: 1.65 [CI: 1.30–2.11]) had strongest association with 28‐day mortality (p < .0001). In contrast, SOFA scores at 48 and 96 h as well as Δ‐SOFA: 48‐0 h and Δ‐SOFA: 96‐0 h did not show significant correlations. Among them, merely mean SOFA‐score (HR: 2.28 [CI: 2.21–3.51]; p < .001) remained as independent prognosticator on multivariate regression analysis; though having less odds of predicting value compared with age (HR: 3.81 [CI: 1.98–5.21]), hypertension (HR: 3.11 [CI: 1.26–3.81]), coronary artery disease [CAD] (HR: 2.82 [CI: 1.51–4.8]), and diabetes mellitus (HR: 2.45 [CI: 1.36–2.99]). The area under ROC (AUROC) for mean SOFA‐score (0.77) and highest SOFA‐score (0.71) were larger than other SOFA intervals. Calculating the first 96 h of SOFA trends, it was obtained that fatality rate was <12.3% if the score dropped, between 28.8% and 46.29% if the score remained unchanged, and >50.45% if the score increased. Conclusion To predict the 28‐day mortality among ICU‐admitted COVID‐19 patients, mean SOFA upon first 96 h of ICU stay is reliable; while having inadequate accuracy comparing with well‐acknowledged COVID‐19 mortality predictors (age, diabetes mellitus, hypertension, CAD). Notably, increased SOFA levels in the course of first 96 h of ICU‐admission, prognosticate at least 50% fatality regardless of initial SOFA score.

Project description:BackgroundPatients receiving intravenous thrombolysis (IVT) for acute ischemic stroke are at risk of developing complications, commonly necessitating admission to an intensive care unit (ICU). At present, most IVT is administered in the Emergency Department or in dedicated stroke units, but no evidence-based criteria exist that allow for early identification of patients at increased risk of developing ICU needs. The present study describes a novel prediction score aiming to identify a subpopulation of post-IVT patients at high risk for critical care interventions.MethodsWe retrospectively analyzed data from 301 patients undergoing IVT at our institutions during a 5-year period. Two hundred and ninety patients met inclusion criteria. The sample was randomly divided into a development and a validation cohort. Logistic regression was used to develop a risk score by weighting predictors of critical care needs based on strength of association.ResultsSeventy-two patients (24.8%) required critical care interventions. Black race (odds ratio [OR] 3.81, p=0.006), male sex (OR 3.79, p=0.008), systolic blood pressure (SBP; OR 1.45 per 10 mm Hg increase in SBP, p<0.001), and NIH stroke scale (NIHSS; OR 1.09 per 1 point increase in NIHSS, p=0.071) were independent predictors of critical care needs. The optimal model for score development, predicting critical care needs, achieved an AUC of 0.782 in the validation group. The score was named the ICAT (Intensive Care After Thrombolysis) score, assigning the following points: black race (1 point), male sex (1 point), SBP (2 points if 160-200 mm Hg; 4 points if >200 mm Hg), and NIHSS (1 point if 7-12; 2 points if >12). Each 1-point increase in the score was associated with 2.22-fold increased odds for critical care needs (95% CI 1.78-2.76, p<0.001). A score ≥ 2 was associated with over 13 times higher odds of critical care needs compared to a score <2 (OR 13.60, 95% CI 3.23-57.19), predicting critical care with 97.2% sensitivity and 28.0% specificity.ConclusionThe ICAT score, combining information about race, sex, SBP, and NIHSS, predicts critical care needs in post-IVT patients and may be helpful when triaging post-IVT patients to the appropriate monitoring environment.

Dataset Information

[C-Reactive protein and SOFA scale: A simple score as early predictor of critical care requirement in patients with COVID-19 pneumonia in Spain].

Objective

Material and methods

Measurements and main results

Conclusion

Publications

[C-Reactive protein and SOFA scale: A simple score as early predictor of critical care requirement in patients with COVID-19 pneumonia in Spain].

Similar Datasets

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