In-Hospital Mortality of COVID-19 Patients Treated with High-Flow Nasal Oxygen: Evaluation of Biomarkers and Development of the Novel Risk Score Model CROW-65

To replace mechanical ventilation (MV), which represents the cornerstone therapy in severe COVID-19 cases, high-flow nasal oxygen (HFNO) therapy has recently emerged as a less-invasive therapeutic possibility for those patients. Respecting the risk of MV delay as a result of HFNO use, we aimed to ev...

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Vydáno v:Life (Basel, Switzerland) Ročník 11; číslo 8; s. 735
Hlavní autoři: Kljakovic Gaspic, Toni, Pavicic Ivelja, Mirela, Kumric, Marko, Matetic, Andrija, Delic, Nikola, Vrkic, Ivana, Bozic, Josko
Médium: Journal Article
Jazyk:angličtina
Vydáno: Switzerland MDPI AG 23.07.2021
MDPI
Témata:
Biomarkers
Chronic illnesses
COVID-19
Evaluation
HFNO
in-hospital outcomes
Mechanical ventilation
Mortality
Multivariate analysis
Oxygen
Patients
Risk
risk scores
Subgroups
Ventilators
COVID-19
mechanical ventilation
risk scores
HFNO
in-hospital outcomes
ISSN:2075-1729, 2075-1729
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Shrnutí:To replace mechanical ventilation (MV), which represents the cornerstone therapy in severe COVID-19 cases, high-flow nasal oxygen (HFNO) therapy has recently emerged as a less-invasive therapeutic possibility for those patients. Respecting the risk of MV delay as a result of HFNO use, we aimed to evaluate which parameters could determine the risk of in-hospital mortality in HFNO-treated COVID-19 patients. This single-center cohort study included 102 COVID-19-positive patients treated with HFNO. Standard therapeutic methods and up-to-date protocols were used. Patients who underwent a fatal event (41.2%) were significantly older, mostly male patients, and had higher comorbidity burdens measured by CCI. In a univariate analysis, older age, shorter HFNO duration, ventilator initiation, higher CCI and lower ROX index all emerged as significant predictors of adverse events (p < 0.05). Variables were dichotomized and included in the multivariate analysis to define their relative weights in the computed risk score model. Based on this, a risk score model for the prediction of in-hospital mortality in COVID-19 patients treated with HFNO consisting of four variables was defined: CCI > 4, ROX index ≤ 4.11, LDH-to-WBC ratio, age > 65 years (CROW-65). The main purpose of CROW-65 is to address whether HFNO should be initiated in the subgroup of patients with a high risk of in-hospital mortality.
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ISSN:2075-1729
2075-1729
DOI:10.3390/life11080735