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Role of ROX index in the first assessment of COVID-19 patients in the emergency department

During the first outbreak of Coronavirus disease 2019 (COVID-19) Emergency Departments (EDs) were overcrowded. Hence, the need for a rapid and simple tool to support clinical decisions, such as the ROX index (Respiratory rate – OXygenation), defined as the ratio of peripheral oxygen saturation and f...

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Autores principales: Gianstefani, Alice, Farina, Gabriele, Salvatore, Veronica, Alvau, Francesca, Artesiani, Maria Laura, Bonfatti, Sara, Campinoti, Francesca, Caramella, Ilaria, Ciordinik, Michele, Lorusso, Andrea, Nanni, Sara, Nizza, Daniela, Nava, Stefano, Giostra, Fabrizio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7917022/
https://www.ncbi.nlm.nih.gov/pubmed/33646507
http://dx.doi.org/10.1007/s11739-021-02675-2
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author Gianstefani, Alice
Farina, Gabriele
Salvatore, Veronica
Alvau, Francesca
Artesiani, Maria Laura
Bonfatti, Sara
Campinoti, Francesca
Caramella, Ilaria
Ciordinik, Michele
Lorusso, Andrea
Nanni, Sara
Nizza, Daniela
Nava, Stefano
Giostra, Fabrizio
author_facet Gianstefani, Alice
Farina, Gabriele
Salvatore, Veronica
Alvau, Francesca
Artesiani, Maria Laura
Bonfatti, Sara
Campinoti, Francesca
Caramella, Ilaria
Ciordinik, Michele
Lorusso, Andrea
Nanni, Sara
Nizza, Daniela
Nava, Stefano
Giostra, Fabrizio
author_sort Gianstefani, Alice
collection PubMed
description During the first outbreak of Coronavirus disease 2019 (COVID-19) Emergency Departments (EDs) were overcrowded. Hence, the need for a rapid and simple tool to support clinical decisions, such as the ROX index (Respiratory rate – OXygenation), defined as the ratio of peripheral oxygen saturation and fraction of inspired oxygen, to respiratory rate. The aim of the study was to evaluate the accuracy of the ROX index in predicting hospitalization and mortality in patients with a diagnosis of COVID-19 in the ED. The secondary outcomes were to assess the number of readmissions and the variations in the ROX index between the first and the second admission. This was an observational prospective monocentric study, carried out in the ED of Sant’Orsola-Malpighi Hospital in Bologna, Italy. Five hundred and fifty-four consecutive patients with COVID-19 were enrolled and the ROX index was calculated. Patients were followed until hospital discharge or death. A ROX index value < 25.7 was associated with hospitalization (area under the curve [AUC] = 0.737, 95% CI 0.696–0.779, p < 0.001). The ROX index < 22.3 was statistically related to higher 30-day mortality (AUC = 0.764, 95% CI 0.708–0.820, p < 0.001). Eight patients were discharged and returned to the ED within the subsequent 7 days, their mean ROX index was 30.3 (6.2; range 21.9–39.4) at the first assessment and 24.6 (5.5; 14.5–29.5) at the second assessment, (p = 0.012). The ROX index, together with laboratory, imaging and clinical findings, correlated with the need for hospital admission, mechanical ventilation and mortality risk in COVID-19 patients.
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spelling pubmed-79170222021-03-01 Role of ROX index in the first assessment of COVID-19 patients in the emergency department Gianstefani, Alice Farina, Gabriele Salvatore, Veronica Alvau, Francesca Artesiani, Maria Laura Bonfatti, Sara Campinoti, Francesca Caramella, Ilaria Ciordinik, Michele Lorusso, Andrea Nanni, Sara Nizza, Daniela Nava, Stefano Giostra, Fabrizio Intern Emerg Med EM - Original During the first outbreak of Coronavirus disease 2019 (COVID-19) Emergency Departments (EDs) were overcrowded. Hence, the need for a rapid and simple tool to support clinical decisions, such as the ROX index (Respiratory rate – OXygenation), defined as the ratio of peripheral oxygen saturation and fraction of inspired oxygen, to respiratory rate. The aim of the study was to evaluate the accuracy of the ROX index in predicting hospitalization and mortality in patients with a diagnosis of COVID-19 in the ED. The secondary outcomes were to assess the number of readmissions and the variations in the ROX index between the first and the second admission. This was an observational prospective monocentric study, carried out in the ED of Sant’Orsola-Malpighi Hospital in Bologna, Italy. Five hundred and fifty-four consecutive patients with COVID-19 were enrolled and the ROX index was calculated. Patients were followed until hospital discharge or death. A ROX index value < 25.7 was associated with hospitalization (area under the curve [AUC] = 0.737, 95% CI 0.696–0.779, p < 0.001). The ROX index < 22.3 was statistically related to higher 30-day mortality (AUC = 0.764, 95% CI 0.708–0.820, p < 0.001). Eight patients were discharged and returned to the ED within the subsequent 7 days, their mean ROX index was 30.3 (6.2; range 21.9–39.4) at the first assessment and 24.6 (5.5; 14.5–29.5) at the second assessment, (p = 0.012). The ROX index, together with laboratory, imaging and clinical findings, correlated with the need for hospital admission, mechanical ventilation and mortality risk in COVID-19 patients. Springer International Publishing 2021-03-01 2021 /pmc/articles/PMC7917022/ /pubmed/33646507 http://dx.doi.org/10.1007/s11739-021-02675-2 Text en © Società Italiana di Medicina Interna (SIMI) 2021 This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.
spellingShingle EM - Original
Gianstefani, Alice
Farina, Gabriele
Salvatore, Veronica
Alvau, Francesca
Artesiani, Maria Laura
Bonfatti, Sara
Campinoti, Francesca
Caramella, Ilaria
Ciordinik, Michele
Lorusso, Andrea
Nanni, Sara
Nizza, Daniela
Nava, Stefano
Giostra, Fabrizio
Role of ROX index in the first assessment of COVID-19 patients in the emergency department
title Role of ROX index in the first assessment of COVID-19 patients in the emergency department
title_full Role of ROX index in the first assessment of COVID-19 patients in the emergency department
title_fullStr Role of ROX index in the first assessment of COVID-19 patients in the emergency department
title_full_unstemmed Role of ROX index in the first assessment of COVID-19 patients in the emergency department
title_short Role of ROX index in the first assessment of COVID-19 patients in the emergency department
title_sort role of rox index in the first assessment of covid-19 patients in the emergency department
topic EM - Original
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7917022/
https://www.ncbi.nlm.nih.gov/pubmed/33646507
http://dx.doi.org/10.1007/s11739-021-02675-2
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