Giá trị tiên lượng của thang điểm MPRIEST trên bệnh nhân COVID-19 nhập viện tại thành phố Hồ Chí Minh

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Tác giả: Huy Hoàng Đặng, Ngọc Quốc Duy Đỗ, Thị Xuân Diệu Nguyễn, Tuấn Anh Nguyễn, Hoàng Phong Ninh, Ngọc Huy Phạm, Thị Thảo Phạm, Hải Nam Phan, Quý Khoa, Thị Ngân Tô, Ngọc Nguyên Trần, Niên Kỷ Trần, Phúc An Trần, Trình Ngọc Khánh Văn, Ngọc Trang Võ

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Y học lâm sàng Bệnh viện Trung ương Huế, 2023

Mô tả vật lý: tr.37-44

Bộ sưu tập: Metadata

ID: 369757

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ABSTRACT PROGNOSTIC ACCURACY OF MPRIEST FOR ADVERSE OUTCOMES WITHIN 30 DAYS OF HOSPITALIZED COVID-19 PATIENTS IN HO CHI MINH CITY Do Ngoc Quoc Duy1, Tran Ngoc Nguyen2, Tran Phuc An1, Dang Huy Hoang1, Tran Nien Ky1, Phan Hai Nam1, To Thi Ngan1, Ninh Hoang Phong1, Pham Thi Thao1, Vo Ngoc Trang1, Pham Ngoc Huy1, Van Trinh Ngoc Khanh1, Quy Khoa3, Nguyen Thi Xuan Dieu3, Nguyen Tuan Anh4 Objectives: The need for a simple yet effective tool to predict the severity of COVID-19 patients is essential. The mPRIEST score has been applied in some countries and contributed to solving the problem of health resource allocation. We aimed to investigate the prognostic accuracy of mPRIEST for adverse outcome of hospitalized COVID-19 patients in the Vietnamese population. Methods: We conducted a retrospective observational cohort study of hospitalized COVID-19 patients at the Emergency Department in the University Medical Center Ho Chi Minh City during the period from April 2021 to January 2022. We collected data from the electronic medical record system, the information of variables at the time of admission to assess the mPRIREST score value. We used 30-day outcome data (death or receiving respiratory, cardiovascular or renal support) to determine the prognostic accuracy for adverse outcomes of the mPRIEST score. Results: We analysed data of 339 adults, of whom 142 (41.9%) died or got organ support. Out of the 90 patients who died, 88 (97.8%) received at least one organ support. C-statistics (AUC) of the mPRIEST score for the overall outcome, death and organ support was 0.77 (95% CI 0.72 - 0.82)
0.72 (CI 95% 0.66 - 0.78)
and 0.77 (95% CI 0.72 - 0.82), respectively. A cut - off >
9 points for a sensitivity of 65.5% and a specificity of 75.1%. Conclusion: This data suggests that the mPRIEST score, which can be assessed from clinical variables alone, has potential for use in Emergency Department to predict mortality or organ support within 30 - day of hospitalized COVID-19 patients. This should be confirmed in more validation studies in diverse settingsĐặt vấn đề: Một công cụ đơn giản mà hiệu quả để tiên lượng mức độ nặng cho bệnh nhân COVID-19 là rất cần thiết trên lâm sàng. Thang điểm mPRIEST đã được ứng dụng tại một số quốc gia và góp phần giúp giải quyết vấn đề phân bố nguồn lực y tế. Nghiên cứu này nhằm khảo sát giá trị tiên lượng nặng của thang điểm mPRIEST cho bệnh nhân COVID-19 nhập viện trên dân số Việt Nam. Đối tượng, phương pháp: Chúng tôi thực hiện một nghiên cứu đoàn hệ hồi cứu những bệnh nhân COVID-19 nhập viện tại khoa Cấp cứu, bệnh viện Đại học Y Dược Thành phố Hồ Chí Minh trong khoảng thời gian từ 04/2021 đến 01/2022. Dữ liệu được thu thập từ hệ thống bệnh án điện tử, các thông tin lúc nhập viện để đánh giá điểm theo thang mPRIEST. Kết cục 30 ngày (tử vong, hỗ trợ hô hấp, tim mạch hoặc thận) được dùng để đánh giá giá trị tiên lượng của thang điểm. Kết quả: Trong 339 bệnh nhân người lớn, có 142 (41,9%) bệnh nhân có kết cục bất lợi. Trong 90 bệnh nhân tử vong, có 88 (97,8%) trường hợp có hỗ trợ ít nhất một cơ quan. AUC của thang điểm mPRIEST cho kết cục chung, tử vong, hỗ trợ cơ quan lần lượt là 0,77 (KTC 95% 0,72 - 0,82)
0,72 (KTC 95% 0,66 - 0,78)
0,77 (KTC 95% 0,72 - 0,82). Ngưỡng cắt >
9 điểm cho độ nhạy 65,5% và độ đặc hiệu 75,1%. Kết luận: Thang điểm mPRIEST có giá trị trong thực hành lâm sàng để tiên lượng kết cục tử vong hoặc hỗ trợ cơ quan trong vòng 30 ngày trên bệnh nhân COVID-19 nhập viện

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