PDF(Pubmed)
Abstract：
BACKGROUND: With COVID-19 becoming a common disease, primary care facilities such as clinics are required to efficiently triage patients at high risk of severe illness within the constraints of limited medical resources. However, existing COVID-19 severity risk scores require detailed medical history assessments, such as evaluating the severity of pneumonia via chest CT and accounting for past and comorbid conditions. Therefore, they may not be suitable for practical use in clinical settings with limited medical resources, including personnel and equipment.
OBJECTIVE: The goal is to identify key variables that predict the need for oxygen therapy in COVID-19 patients and develop a simplified clinical risk score based solely on vital signs to predict oxygen requirements.
METHODS: A retrospective observational study of 584 outpatients with COVID-19 confirmed by polymerase chain reaction test visited Sasebo Chuo Hospital between April 28, 2022, and August 18, 2022. Analyses were conducted after adjustment for background factors of age and sex with propensity score matching. We used the Fisher test for nominal variables and the Kruskal-Wallis test for continuous variables.
RESULTS: After adjusting for age and sex, several factors significantly correlated with the need for oxygen within seven days including body temperature (p < 0.001), respiratory rate (p = 0.007), SpO2 (p < 0.001), and the detection of pneumonia on CT scans (p = 0.032). The area under the receiver-operating characteristic curve for the risk score based on these vital signs and CT was 0.947 (95% confidence interval: 0.911-0.982). The risk score based solely on vital signs was 0.937 (0.900-0.974), demonstrating the ability to predict oxygen administration with no significant differences.
CONCLUSIONS: Body temperature, advanced age, increased respiratory rate, decreased SpO2, and the presence of pneumonia on CT scans were significant predictors of oxygen need within seven days among the study participants. The risk score, based solely on vital signs, effectively and simply assesses the likelihood of requiring oxygen therapy within seven days with high accuracy. The risk score, which utilizes only age and vital signs and does not require a detailed patient history or CT scans, could streamline hospital referral processes for admissions.
OBJECTIVE: The goal is to identify key variables that predict the need for oxygen therapy in COVID-19 patients and develop a simplified clinical risk score based solely on vital signs to predict oxygen requirements.
METHODS: A retrospective observational study of 584 outpatients with COVID-19 confirmed by polymerase chain reaction test visited Sasebo Chuo Hospital between April 28, 2022, and August 18, 2022. Analyses were conducted after adjustment for background factors of age and sex with propensity score matching. We used the Fisher test for nominal variables and the Kruskal-Wallis test for continuous variables.
RESULTS: After adjusting for age and sex, several factors significantly correlated with the need for oxygen within seven days including body temperature (p < 0.001), respiratory rate (p = 0.007), SpO2 (p < 0.001), and the detection of pneumonia on CT scans (p = 0.032). The area under the receiver-operating characteristic curve for the risk score based on these vital signs and CT was 0.947 (95% confidence interval: 0.911-0.982). The risk score based solely on vital signs was 0.937 (0.900-0.974), demonstrating the ability to predict oxygen administration with no significant differences.
CONCLUSIONS: Body temperature, advanced age, increased respiratory rate, decreased SpO2, and the presence of pneumonia on CT scans were significant predictors of oxygen need within seven days among the study participants. The risk score, based solely on vital signs, effectively and simply assesses the likelihood of requiring oxygen therapy within seven days with high accuracy. The risk score, which utilizes only age and vital signs and does not require a detailed patient history or CT scans, could streamline hospital referral processes for admissions.
摘要：
背景：随着COVID-19成为一种常见疾病，需要诊所等初级保健设施，在有限的医疗资源限制下，有效地分诊严重疾病高危患者。然而,现有的COVID-19严重程度风险评分需要详细的病史评估，例如通过胸部CT评估肺炎的严重程度，并考虑过去和共病条件。因此,它们可能不适合在医疗资源有限的临床环境中实际使用，包括人员和设备。
目的：目的是确定预测COVID-19患者需要氧疗的关键变量，并根据生命体征制定简化的临床风险评分，以预测需氧量。
方法：2022年4月28日至2022年8月18日，一项对584例经聚合酶链反应试验确诊的COVID-19门诊患者进行的回顾性观察性研究访问了佐世保中央医院。在对年龄和性别的背景因素进行调整后，采用倾向得分匹配进行分析。我们对名义变量使用Fisher检验，对连续变量使用Kruskal-Wallis检验。
结果：在调整了年龄和性别之后，一些因素与七天内的氧气需求显着相关，包括体温（p<0.001），呼吸频率（p=0.007），SpO2（p<0.001），以及CT扫描中肺炎的检测（p=0.032）。基于这些生命体征和CT的风险评分的受试者工作特征曲线下面积为0.947（95％置信区间：0.911-0.982）。仅基于生命体征的风险评分为0.937（0.900-0.974），证明了预测氧气给药的能力，没有显着差异。
结论：体温，高龄,呼吸频率增加，在研究参与者中,SpO2降低和CT扫描出现肺炎是7天内需氧的重要预测因素.风险评分，仅基于生命体征，有效和简单地评估需要氧气治疗的可能性在7天内高准确性。风险评分，它只利用年龄和生命体征，不需要详细的病史或CT扫描，可以简化入院的医院转诊流程。
目的：目的是确定预测COVID-19患者需要氧疗的关键变量，并根据生命体征制定简化的临床风险评分，以预测需氧量。
方法：2022年4月28日至2022年8月18日，一项对584例经聚合酶链反应试验确诊的COVID-19门诊患者进行的回顾性观察性研究访问了佐世保中央医院。在对年龄和性别的背景因素进行调整后，采用倾向得分匹配进行分析。我们对名义变量使用Fisher检验，对连续变量使用Kruskal-Wallis检验。
结果：在调整了年龄和性别之后，一些因素与七天内的氧气需求显着相关，包括体温（p<0.001），呼吸频率（p=0.007），SpO2（p<0.001），以及CT扫描中肺炎的检测（p=0.032）。基于这些生命体征和CT的风险评分的受试者工作特征曲线下面积为0.947（95％置信区间：0.911-0.982）。仅基于生命体征的风险评分为0.937（0.900-0.974），证明了预测氧气给药的能力，没有显着差异。
结论：体温，高龄,呼吸频率增加，在研究参与者中,SpO2降低和CT扫描出现肺炎是7天内需氧的重要预测因素.风险评分，仅基于生命体征，有效和简单地评估需要氧气治疗的可能性在7天内高准确性。风险评分，它只利用年龄和生命体征，不需要详细的病史或CT扫描，可以简化入院的医院转诊流程。
