The RALE Score Versus the CT Severity Score in Invasively Ventilated COVID-19 Patients-A Retrospective Study Comparing Their Prognostic Capacities.

Data de publicació: 26/08/2022 Data Ahead of Print: 26/08/2022

Autors de IIS La Fe

Guido Mazzinari

Autor

Autors aliens a IIS La Fe

Valk, Christel M.
Zimatore, Claudio
Pierrakos, Charalampos
Sivakorn, Chaisith
Dechsanga, Jutamas
Grasso, Salvatore
Beenen, Ludo
Bos, Lieuwe D. J.
Paulus, Frederique
Schultz, Marcus J.
Pisani, Luigi

Grups d'Investigació

Medicina Perioperatoria, Anestesiología y Reanimación

Leader

Óscar Díaz Cambronero

Abstract

Background: Quantitative radiological scores for the extent and severity of pulmonary infiltrates based on chest radiography (CXR) and computed tomography (CT) scan are increasingly used in critically ill invasively ventilated patients. This study aimed to determine and compare the prognostic capacity of the Radiographic Assessment of Lung Edema (RALE) score and the chest CT Severity Score (CTSS) in a cohort of invasively ventilated patients with acute respiratory distress syndrome (ARDS) due to COVID-19. Methods: Two-center retrospective observational study, including consecutive invasively ventilated COVID-19 patients. Trained scorers calculated the RALE score of first available CXR and the CTSS of the first available CT scan. The primary outcome was ICU mortality; secondary outcomes were duration of ventilation in survivors, length of stay in ICU, and hospital-, 28-, and 90-day mortality. Prognostic accuracy for ICU death was expressed using odds ratios and Area Under the Receiver Operating Characteristic curves (AUROC). Results: A total of 82 patients were enrolled. The median RALE score (22 [15-37] vs. 26 [20-39]; p = 0.34) and the median CTSS (18 [16-21] vs. 21 [18-23]; p = 0.022) were both lower in ICU survivors compared to ICU non-survivors, although only the difference in CTSS reached statistical significance. While no association was observed between ICU mortality and RALE score (OR 1.35 [95%CI 0.64-2.84]; p = 0.417; AUC 0.50 [0.44-0.56], this was noticed with the CTSS (OR, 2.31 [1.22-4.38]; p = 0.010) although with poor prognostic capacity (AUC 0.64 [0.57-0.69]). The correlation between the RALE score and CTSS was weak (r(2) = 0.075; p = 0.012). Conclusions: Despite poor prognostic capacity, only CTSS was associated with ICU mortality in our cohort of COVID-19 patients.

Dades de la publicació

ISSN/ISSNe:: 2075-4418, 2075-4418
Tipus:: Article
Pàgines:: -
DOI:: 10.3390/diagnostics12092072
PubMed:: 36140474
Factor d'Impacte:: 0,658 SCImago ℠
Quartil:: Q2 SCImago ℠

Documents

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Mètriques

Filiacions

Valk, Christel M.:: 1 Amsterdam UMC, Locat AMC, Dept Intens Care, NL-1105 AZ Amsterdam, Netherlands, Países Bajos.
Zimatore, Claudio:: Amsterdam UMC, Locat AMC, Dept Intens Care, NL-1105 AZ Amsterdam, Netherlands

Amsterdam UMC, Locat AMC, Lab Expt Intens Care & Anesthesiol LEICA, NL-1105 AZ Amsterdam, Netherlands

Univ Bari Aldo Moro, Dept Emergency & Organ Transplantat, I-70124 Bari, Italy
Mazzinari, Guido:: 4 Hosp Univ & Politecn La Fe, Dept Anaesthesiol & Crit Care, Valencia 46026, Spain, España.

Instituto de Investigación. 5 Inst Invest Sanitaria La Fe, Perioperat Med Res Grp, Valencia 46026, Spain, España.
Pierrakos, Charalampos:: Amsterdam UMC, Locat AMC, Dept Intens Care, NL-1105 AZ Amsterdam, Netherlands

Amsterdam UMC, Locat AMC, Lab Expt Intens Care & Anesthesiol LEICA, NL-1105 AZ Amsterdam, Netherlands

Ctr Hosp Univ Brussels, Dept Intens Care, B-1020 Brussels, Belgium
Sivakorn, Chaisith:: NHS Fdn Trust, Univ Coll London Hosp, Intens Care Unit, London NW1 2BU, England
Dechsanga, Jutamas:: Chonburi Hosp, Dept Med, Div Pulm & Crit Care, Chon Buri 20000, Thailand
Grasso, Salvatore:: Univ Bari Aldo Moro, Dept Emergency & Organ Transplantat, I-70124 Bari, Italy
Beenen, Ludo:: Amsterdam UMC, Locat AMC, Dept Radiol, NL-1105 AZ Amsterdam, Netherlands
Bos, Lieuwe D. J.:: Amsterdam UMC, Locat AMC, Dept Intens Care, NL-1105 AZ Amsterdam, Netherlands

Amsterdam UMC, Locat AMC, Lab Expt Intens Care & Anesthesiol LEICA, NL-1105 AZ Amsterdam, Netherlands

Amsterdam UMC, Locat AMC, Dept Pulmonol, NL-1105 AZ Amsterdam, Netherlands
Paulus, Frederique:: Amsterdam UMC, Locat AMC, Dept Intens Care, NL-1105 AZ Amsterdam, Netherlands

Amsterdam UMC, Locat AMC, Lab Expt Intens Care & Anesthesiol LEICA, NL-1105 AZ Amsterdam, Netherlands
Schultz, Marcus J.:: Amsterdam UMC, Locat AMC, Dept Intens Care, NL-1105 AZ Amsterdam, Netherlands

Amsterdam UMC, Locat AMC, Lab Expt Intens Care & Anesthesiol LEICA, NL-1105 AZ Amsterdam, Netherlands

Mahidol Univ, Mahidol Oxford Trop Med Res Unit MORU, Bangkok 10400, Thailand

Univ Oxford, Nuffield Dept Med, Oxford OX1 2JD, England
Pisani, Luigi:: Amsterdam UMC, Locat AMC, Dept Intens Care, NL-1105 AZ Amsterdam, Netherlands

Amsterdam UMC, Locat AMC, Lab Expt Intens Care & Anesthesiol LEICA, NL-1105 AZ Amsterdam, Netherlands

Mahidol Univ, Mahidol Oxford Trop Med Res Unit MORU, Bangkok 10400, Thailand

Miulli Reg Hosp, Anaesthesia & Intens Care Unit, I-70021 Acquaviva Delle Fonti, Italy

Keywords

ARDS; ICU; coronavirus disease 2019; mechanical ventilation; chest X-ray; chest computed tomography; chest imaging; RALE score; CT severity score; CTSS