Objective:To validate a better scoring system between CURB-65 and the pneumonia severity index(PSI)to predict the need for intensive care unit admission and 30-day mortality in patients with COVID-19 pneumonia.Methods...Objective:To validate a better scoring system between CURB-65 and the pneumonia severity index(PSI)to predict the need for intensive care unit admission and 30-day mortality in patients with COVID-19 pneumonia.Methods:A retrospective cohort study was conducted on patients in a tertiary care hospital in Kota,Rajasthan.Relevant data about history,and general and systemic examination with laboratory investigations was collected.Patients were categorized into different risk groups for ICU admission and 30-day mortality according to CURB-65 and PSI.Sensitivity,specificity,positive predictive value,negative predictive value,and area under the curve were calculated.Continuous variables,means and percentages were compared using the t-test for numerical data and the Chi-square test for nominal data.Results:100 patients who tested positive for SARS-CoV-2 by RT-PCR were included;67 were male and 33 were female.58 patients had severe disease(SpO2≤90%)and 30 patients died.CURB-65 had an area under the curve(AUC)of 0.81 for predicting ICU admission,with a sensitivity of 92%and a specificity of 54%for high risk patients.Meanwhile,PSI had an AUC of 0.88,with a sensitivity of 83%and a specificity of 73%in high risk patients.In addition,CURB-65 had an AUC of 0.79 for predicting 30-day mortality,with a sensitivity of 60%and a specificity of 89%in high risk patients.PSI had an AUC of 0.71 for predicting 30-day mortality,with a sensitivity of 90%and a specificity of 46%in high risk patients.Conclusions:This single-centre retrospective study involving a cohort of COVID-19 patients demonstrates that CURB-65 and PSI are powerful tools for predicting mortality.However,PSI appears to be slightly better at predicting the need for intensive care unit admission in high-risk patients.展开更多
文摘Objective:To validate a better scoring system between CURB-65 and the pneumonia severity index(PSI)to predict the need for intensive care unit admission and 30-day mortality in patients with COVID-19 pneumonia.Methods:A retrospective cohort study was conducted on patients in a tertiary care hospital in Kota,Rajasthan.Relevant data about history,and general and systemic examination with laboratory investigations was collected.Patients were categorized into different risk groups for ICU admission and 30-day mortality according to CURB-65 and PSI.Sensitivity,specificity,positive predictive value,negative predictive value,and area under the curve were calculated.Continuous variables,means and percentages were compared using the t-test for numerical data and the Chi-square test for nominal data.Results:100 patients who tested positive for SARS-CoV-2 by RT-PCR were included;67 were male and 33 were female.58 patients had severe disease(SpO2≤90%)and 30 patients died.CURB-65 had an area under the curve(AUC)of 0.81 for predicting ICU admission,with a sensitivity of 92%and a specificity of 54%for high risk patients.Meanwhile,PSI had an AUC of 0.88,with a sensitivity of 83%and a specificity of 73%in high risk patients.In addition,CURB-65 had an AUC of 0.79 for predicting 30-day mortality,with a sensitivity of 60%and a specificity of 89%in high risk patients.PSI had an AUC of 0.71 for predicting 30-day mortality,with a sensitivity of 90%and a specificity of 46%in high risk patients.Conclusions:This single-centre retrospective study involving a cohort of COVID-19 patients demonstrates that CURB-65 and PSI are powerful tools for predicting mortality.However,PSI appears to be slightly better at predicting the need for intensive care unit admission in high-risk patients.
