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Chest X-ray Score and Frailty as Predictors of In-Hospital Mortality in Older Adults with COVID-19

Background. The purpose of this study was to evaluate the prognostic impact of chest X-ray (CXR) score, frailty, and clinical and laboratory data on in-hospital mortality of hospitalized older patients with COVID-19. Methods. This retrospective study included 122 patients 65 years or older with posi...

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Autores principales: Cecchini, Sara, Di Rosa, Mirko, Soraci, Luca, Fumagalli, Alessia, Misuraca, Clementina, Colombo, Daniele, Piomboni, Iacopo, Carnevali, Francesca, Paci, Enrico, Galeazzi, Roberta, Giordano, Piero, Fedecostante, Massimiliano, Cherubini, Antonio, Lattanzio, Fabrizia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8268684/
https://www.ncbi.nlm.nih.gov/pubmed/34279449
http://dx.doi.org/10.3390/jcm10132965
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author Cecchini, Sara
Di Rosa, Mirko
Soraci, Luca
Fumagalli, Alessia
Misuraca, Clementina
Colombo, Daniele
Piomboni, Iacopo
Carnevali, Francesca
Paci, Enrico
Galeazzi, Roberta
Giordano, Piero
Fedecostante, Massimiliano
Cherubini, Antonio
Lattanzio, Fabrizia
author_facet Cecchini, Sara
Di Rosa, Mirko
Soraci, Luca
Fumagalli, Alessia
Misuraca, Clementina
Colombo, Daniele
Piomboni, Iacopo
Carnevali, Francesca
Paci, Enrico
Galeazzi, Roberta
Giordano, Piero
Fedecostante, Massimiliano
Cherubini, Antonio
Lattanzio, Fabrizia
author_sort Cecchini, Sara
collection PubMed
description Background. The purpose of this study was to evaluate the prognostic impact of chest X-ray (CXR) score, frailty, and clinical and laboratory data on in-hospital mortality of hospitalized older patients with COVID-19. Methods. This retrospective study included 122 patients 65 years or older with positive reverse transcription polymerase chain reaction for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and with availability to CXRs on admission. The primary outcome of the study was in-hospital mortality. Statistical analysis was conducted using Cox regression. The predictive ability of the CXR score was compared with the Clinical Frailty Scale (CFS) and fever data using Area Under the Curve (AUC) and net reclassification improvement (NRI) statistics. Results. Of 122 patients, 67 died during hospital stay (54.9%). The CXR score (HR: 1.16, 95% CI, 1.04–1.28), CFS (HR: 1.27; 95% CI, 1.09–1.47), and presence of fever (HR: 1.75; 95% CI, 1.03–2.97) were significant predictors of in-hospital mortality. The addition of both the CFS and presence of fever to the CXR score significantly improved the prediction of in-hospital mortality (NRI, 0.460; 95% CI, 0.102 to 0.888; AUC difference: 0.117; 95% CI, 0.041 to 0.192, p = 0.003). Conclusions. CXR score, CFS, and presence of fever were the main predictors of in-hospital mortality in our cohort of hospitalized older patients with COVID-19. Adding frailty and presence of fever to the CXR score statistically improved predictive accuracy compared to single risk factors.
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spelling pubmed-82686842021-07-10 Chest X-ray Score and Frailty as Predictors of In-Hospital Mortality in Older Adults with COVID-19 Cecchini, Sara Di Rosa, Mirko Soraci, Luca Fumagalli, Alessia Misuraca, Clementina Colombo, Daniele Piomboni, Iacopo Carnevali, Francesca Paci, Enrico Galeazzi, Roberta Giordano, Piero Fedecostante, Massimiliano Cherubini, Antonio Lattanzio, Fabrizia J Clin Med Article Background. The purpose of this study was to evaluate the prognostic impact of chest X-ray (CXR) score, frailty, and clinical and laboratory data on in-hospital mortality of hospitalized older patients with COVID-19. Methods. This retrospective study included 122 patients 65 years or older with positive reverse transcription polymerase chain reaction for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and with availability to CXRs on admission. The primary outcome of the study was in-hospital mortality. Statistical analysis was conducted using Cox regression. The predictive ability of the CXR score was compared with the Clinical Frailty Scale (CFS) and fever data using Area Under the Curve (AUC) and net reclassification improvement (NRI) statistics. Results. Of 122 patients, 67 died during hospital stay (54.9%). The CXR score (HR: 1.16, 95% CI, 1.04–1.28), CFS (HR: 1.27; 95% CI, 1.09–1.47), and presence of fever (HR: 1.75; 95% CI, 1.03–2.97) were significant predictors of in-hospital mortality. The addition of both the CFS and presence of fever to the CXR score significantly improved the prediction of in-hospital mortality (NRI, 0.460; 95% CI, 0.102 to 0.888; AUC difference: 0.117; 95% CI, 0.041 to 0.192, p = 0.003). Conclusions. CXR score, CFS, and presence of fever were the main predictors of in-hospital mortality in our cohort of hospitalized older patients with COVID-19. Adding frailty and presence of fever to the CXR score statistically improved predictive accuracy compared to single risk factors. MDPI 2021-07-01 /pmc/articles/PMC8268684/ /pubmed/34279449 http://dx.doi.org/10.3390/jcm10132965 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Cecchini, Sara
Di Rosa, Mirko
Soraci, Luca
Fumagalli, Alessia
Misuraca, Clementina
Colombo, Daniele
Piomboni, Iacopo
Carnevali, Francesca
Paci, Enrico
Galeazzi, Roberta
Giordano, Piero
Fedecostante, Massimiliano
Cherubini, Antonio
Lattanzio, Fabrizia
Chest X-ray Score and Frailty as Predictors of In-Hospital Mortality in Older Adults with COVID-19
title Chest X-ray Score and Frailty as Predictors of In-Hospital Mortality in Older Adults with COVID-19
title_full Chest X-ray Score and Frailty as Predictors of In-Hospital Mortality in Older Adults with COVID-19
title_fullStr Chest X-ray Score and Frailty as Predictors of In-Hospital Mortality in Older Adults with COVID-19
title_full_unstemmed Chest X-ray Score and Frailty as Predictors of In-Hospital Mortality in Older Adults with COVID-19
title_short Chest X-ray Score and Frailty as Predictors of In-Hospital Mortality in Older Adults with COVID-19
title_sort chest x-ray score and frailty as predictors of in-hospital mortality in older adults with covid-19
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8268684/
https://www.ncbi.nlm.nih.gov/pubmed/34279449
http://dx.doi.org/10.3390/jcm10132965
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