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NEWS scale prognostic value in patients with pulmonary embolism and COVID-19статья
- Авторы: Kadantseva K., Likhvantsev V., Berikashvili L., Chaus N., Yadgarov M., Kuzovlev A.
- Сборник: EUROPEAN JOURNAL OF ANAESTHESIOLOGY
- Серия: 6847
- Год издания: 2021
- Аннотация: Background: It is considered to be fact of the matter that pulmonary embolism (PE) frequently complicates SARS-CoV-2 [1]. However, even now there is lack of knowledge about real predictors of PE in such patients [2]. Goal of Study: To investigate if comorbidity of the patient and severity of COVID 19 at the ICU admission can be considered as the predisposing factors PE occurrence. Materials and Methods: A retrospective single-center cohort study on critically ill COVID patients admitted to ICU of the V. Demikhov Municipal Hospital from March to June 2020 (N = 403, 231 men, mean age 62.4±15.3, range 21 to 97) had been performed. After univariant analysis had been finished, Multivariate regression model was applied with the adjustments on for age, SOFA, qSOFA, NEWS, Charlson’s comorbidity index, history of peripheral arterial disease, type 2 diabetes and international normalized ratio (INR) at admission. Results and Discussion: Overall, PE has complicated COVID 19 in 12.9% of patients (52/403): 12.1% (28/231) in men,and 14.0% (24/172) in women, p = 0.653. In univariate analysis, an increase in the Charlson comorbidity index (OR: 1.20, 95% CI: 1.09-1.31, p<0.001) and an increase in the NEWS score (OR: 1.23, 95% CI: 1.10-1.37, p<0.001) were significantly associated with higher frequency of PE. The optimal cut-off value for the NEWS score was equal to 8 points. Regression analysis showed that patients with a NEWS score of 8 or more had a 3.6 times higher odds of PE occurrebce (adj.OR: 3.58, 95% CI: 1.72-7.46, p = 0.001) - PE was observed in 5.6% of patients with less than 8 points on the NEWS scale (10/179) versus 18.8% of patients with 8 or over NEWS’ points (42/224), p<0.001. Conclusion: Patients with COVID 19 who had had 8 or higher score according to the NEWS’ scale had from 1.7 to 7.5 times higher risk of Pulmonary embolism events. This fact may be considered as one more argument in favor of anticoagulants usage for critically ill patients with SARS-CoV-2.
- Добавил в систему: Ядгаров Михаил Яковлевич