Electroencephalogram Image under Complex Domain Analysis Algorithm to Analyze Neurological Status Epilepticus and Poor Prognostic Factors of Children

This study was to adopt the electroencephalogram (EEG) image to analyze the neurological status epilepticus (SE) and adverse prognostic factors of children using the complex domain analysis algorithm, aiming at providing a theoretical basis for the clinical treatment of children with SE. 24-hour EEG was adopted to diagnose 197 children with SE. The patients were divided into an experimental group (100 cases) and a control group (97 cases) using a random number table method. The EEGs of children in the experimental group were analyzed using the compound domain analysis algorithm, and those in the control group were diagnosed by a professional doctor. The indicators of children in two groups were compared to analyze the effect of the compound domain analysis algorithm in diagnosing diseases through EEG. The prognostic scores of 197 children were scored one month after they were diagnosed, treated, and discharged, and the adverse prognostic factors were analyzed. As a result, EEG can accurately and effectively analyze the brain diseases in children. The sensitivity and specificity of the complex domain analysis algorithm for the detection of epilepsy EEG were much higher than those of the EEG automatic detection algorithm based on time-domain waveform similarity and the EEG automatic detection algorithm based on convolutional neural network (CNN), and the average running time was opposite, showing obvious difference ( P < 0.05 ).The average accuracy, sensitivity, and specificity of children in the experimental group were 96.11%, 97.10%, and 95.19%, respectively; and those in the control group were 88.83%, 90.14%, and 87.82%, respectively, so there was an obvious difference in accuracy between two groups ( P < 0.05 ). There were 57 cases with good prognosis and 140 cases with poor prognosis; there were 70 males with good prognosis and 19 poor prognoses and 69 women with good prognosis and 19 poor prognoses. Among 121 patients with infections, 84 cases had good prognosis and 37 cases had poor prognosis; 39 cases of irregular medication had good prognosis in 31 cases and a poor prognosis in 8 cases; and 37 cases had no obvious cause, including 25 cases with good prognosis and 12 cases with poor prognosis. In short, the EEG diagnosis and treatment effect of the compound domain analysis algorithm were better than those of professional doctors; the gender of the patient had no effect on the poor prognosis, and the pathogenic factors had an impact on the poor prognosis of the patient.

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Research on the Correlation of Serum PCT and Plasma GSN Levels with the Prognosis of Urosepsis Patients

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.36.5.2143 ◽

2020 ◽

Vol 36 (5) ◽

Author(s):

Na Cui ◽

Zhanbiao Yu ◽

Zhi Chen ◽

Ning Chen

Keyword(s):

Poor Prognosis ◽

Original Work ◽

Protective Factor ◽

Good Prognosis ◽

Control Group ◽

Creative Commons ◽

The Poor ◽

Prognosis Group ◽

Good Prognosis Group ◽

Open Access Article

Objective: To explore the correlation of procalcitonin (PCT) and gelsolin (GSN) with the prognosis of urosepsis patients. Method: The data of 71 urosepsis patients from March 2015 to April 2019 who were admitted to and treated in Affiliated Hospital of Hebei University were analyzed and compared with those of 92 healthy persons. Serum PCT and plasma GSN levels at different times after treatment were detected. According to prognosis, patients were classified into the good prognosis group or the poor prognosis group. The serum PCT and plasma GSN levels of both groups were compared. Result: The serum PCT level of the urosepsis group on the 1st, 3rd, 5th and 7th days was obviously higher than that of the control group (P<0.05). The plasma GSN levels of the urosepsis group on the 1st, 3rd, 5th and 7th days were obviously lower than those of the control group (P<0.05).The serum PCT level of the poor prognosis group on the 1st, 3rd, 5th and 7th days was obviously higher than that of the good prognosis group (P<0.05). The plasma GSN level of the poor prognosis group on the 1st, 3rd, 5th and 7th days was obviously lower than that of the good prognosis group (P<0.05). PCT was an independent risk factor influencing the prognosis of urosepsis patients and that GSN was a protective factor (P<0.05). Conclusion: The serum PCT and plasma GSN levels can accurately predict the severity and prognosis of urosepsis patients and reflect the disease state of early urosepsis patients. High PCT levels and low GSN levels indicate poor prognosis, and clinicians should consider these values. doi: https://doi.org/10.12669/pjms.36.5.2143 How to cite this:Cui N, Yu Z, Chen Z, Chen N. Research on the Correlation of Serum PCT and Plasma GSN Levels with the Prognosis of Urosepsis Patients. Pak J Med Sci. 2020;36(5):---------. doi: https://doi.org/10.12669/pjms.36.5.2143 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Role of Diffusion Tensor Imaging Combined with Neuron-Specific Enolase and S100 calcium-binding protein B Detection in Predicting the Prognosis of Moderate and Severe Traumatic Brain Injury

10.32592/ircmj.2021.23.4.261 ◽

2021 ◽

Keyword(s):

Poor Prognosis ◽

Neuron Specific Enolase ◽

Good Prognosis ◽

S100b Protein ◽

Control Group ◽

The Poor ◽

Severe Tbi ◽

Prognosis Group ◽

Good Prognosis Group

Background Traumatic brain injury (TBI) seriously affects the quality of life of patients. The present study evaluated the role of diffusion tensor imaging (DTI) combined with Neuron-Specific Enolase (NSE) and S100 calcium-binding protein B (S100B) protein in predicting the prognosis of moderate and severe TBI. Methods The TBI patients were divided into moderate TBI (TBIm) and severe TBI (TBIs) groups according to the Glasgow Coma Scale (GCS) after admission. The patients were then divided into good and poor prognosis groups according to the Glasgow Outcome Scale (GOS); moreover, their follow-ups were recorded at 3 and 6 months after injury. This study also included 65 healthy individuals with matched age and gender as the control group. The fractional anisotropy (FA) values of DTI, serum neuron-specific enolase (NSE), and S100B protein levels were detected in this study. The data were analyzed in SPSS software (version 22.0) to evaluate the role of DTI combined with NSE and S100B protein in predicting the prognosis in TBIm and TBIs. Results: After TBI, the FA values of DTI in the TBI group were lower than those in the control group (P<0.05); moreover, the serum NSE and S100B values in the TBI group were higher than those in the control group (P<0.05). In the TBIm patients, the FA values of the corpus callosum in the good prognosis group were higher than that in the poor prognosis group (P<0.05); however, there was no significant difference between the two groups regarding the FA values of the internal capsule and the cerebral peduncle (P>0.05). The serum levels of NSE and S100B in the good prognosis group were significantly lower than those in the poor prognosis group (P<0.05). In the TBIs patients, the FA value of all areas in the good prognosis group was significantly higher than that in the poor prognosis group (P<0.05). However, there was no significant difference between the two prognosis groups regarding the serum levels of NSE and S100B (P>0.05). Conclusion Although DTI combined with NSE and S100B protein can effectively predict the prognosis of patients with moderate and severe TBI in the early stages, various other measures have been used in the studies to predict the prognosis of TBI patients. Accordingly, comparison with other measures is essential in further studies.

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Clinical Features and Prognostic Factors of Acute Ischemic Stroke Related to Malignant Gastrointestinal Tumor

Frontiers in Neurology ◽

10.3389/fneur.2021.777483 ◽

2021 ◽

Vol 12 ◽

Author(s):

Yating Liu ◽

Xin Li ◽

Feixue Song ◽

Xin Yan ◽

Zhijian Han ◽

...

Keyword(s):

Risk Factors ◽

Ischemic Stroke ◽

Prognostic Factors ◽

Acute Ischemic Stroke ◽

Malignant Tumor ◽

Poor Prognosis ◽

Good Prognosis ◽

Imaging Features ◽

Prognosis Group ◽

D Dimer

Objectives: To analyze the clinical and imaging features of acute ischemic stroke (AIS) related to gastrointestinal malignant tumor, and to explore the prognostic factors.Methods: Clinical data of consecutive patients with gastrointestinal malignant tumor complicated with AIS admitted to the Department of Neurology and Oncology in Lanzhou University Second Hospital from April 2015 to April 2019 were retrospectively analyzed. Patients were divided into good prognosis (mRS 0–2) and poor prognosis (mRS > 2) based on a 90-day mRS score after discharge. The multivariate logistic regression model was used to analyze the prognostic factors.Results: A total of 68 patients were enrolled with an average age of 61.78 ± 6.65 years, including 49 men (72.06%). There were 18 patients in the good prognosis group and 50 patients in the poor prognosis group. The univariate analysis showed that Hcy, D-dimer, thrombin–antithrombin complex (TAT), and three territory sign in magnetic resonance imaging (MRI) were the risk factors for poor prognosis. Multivariate analysis showed that increased D-dimer (OR 4.497, 95% CI 1.014–19.938) and TAT levels (OR 4.294, 95% CI 1.654–11.149) were independent risk factors for the prognosis in such patients.Conclusion: Image of patients with gastrointestinal malignant tumor-related AIS is characterized by three territory sign (multiple lesions in different vascular supply areas). Increased TAT and D-dimer levels are independent prognostic risk factors. TAT is more sensitive to predict prognosis than D-dimer.

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Prognostic significance of immunohistochemical markers in endometrial cancer treated with chemotherapy

Journal of Clinical Oncology ◽

10.1200/jco.2009.27.15_suppl.e16551 ◽

2009 ◽

Vol 27 (15_suppl) ◽

pp. e16551-e16551

Author(s):

S. R. Lord ◽

N. Vasudev ◽

S. Knight ◽

V. Speirs ◽

G. Hall

Keyword(s):

Endometrial Cancer ◽

Prognostic Factors ◽

Poor Prognosis ◽

Early Stage ◽

Good Prognosis ◽

Serous Carcinoma ◽

Positive Staining ◽

Endometrioid Adenocarcinoma ◽

Similar Frequency ◽

Early Stage Endometrial Cancer

e16551 Background: The proportion of patients receiving chemotherapy for endometrial cancer is increasing both in the adjuvant and advanced setting. The literature describes many prognostic immunohistochemical factors in early stage endometrial cancer, the majority of whom will not receive chemotherapy. The aim of this study was to describe the biomarker expression for endometrial tumours treated with chemotherapy and to assess what constitutes a favourable and unfavourable profile for this patient group. Methods: For a subset of patients with either endometrioid, serous or a mixed mullerian morphology treated with chemotherapy at our centre between 1996 and 2008 an immunohistochemical profile of 14 biomarkers was studied (ERα, Erβ1, Erβ2, PR, PRB, P53, Rb, E-cad, MDM2, MIB-1, E2F1, p16, p13, and p21). A univariate analysis using cox regression of potential prognostic factors was then carried out. Results: In total 199 patients received chemotherapy for endometrial cancer over the 12 year period studied. Two year survival from commencement of chemotherapy for patients receiving adjuvant treatment was 45.2% and palliative treatment 28.1%. The commonest histological subtypes were endometrioid adenocarcinoma (40%), serous carcinoma (24.1%) and mixed mullerian tumours (14.6%). For the subset of 35 patients 38.2% of patients had positive immunohistochemical staining for ERα, 53% for PR, 73.5% for p16, and 94% for E2F1. Good prognosis was predicted by the strength of staining for E2F1 (HR 0.757, CI 0.216/0.902, p = 0.025) and poor prognosis by p16 (HR 1.470, CI 1.040/2.077, p = 0.029). Conclusions: Positive staining for ERα and PR was of similar frequency to previous studies of early stage endometrial cancer and did not significantly influence prognosis. Good prognosis correlated with E2F1 expression and poor prognosis with p16. A greater proportion of patients had serous morphology compared to published series of early stage endometrial cancer. Further study of prognostic factors in larger numbers of patients and built into prospective randomised trials may allow the creation of a prognostic model and guide the development of future clinical trials of targeted therapy. No significant financial relationships to disclose.

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Prognostic factor of distal bile duct cancer (DBDC) and ampullary cancer (AC) after pancreatoduodenectomy.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.4_suppl.333 ◽

2017 ◽

Vol 35 (4_suppl) ◽

pp. 333-333

Author(s):

Shinjiro Tomiyasu ◽

Keita Sakamoto ◽

Mitsuhiro Inoue ◽

Masayoshi Iizaka ◽

Nobuyuki Ozaki ◽

...

Keyword(s):

Prognostic Factors ◽

Prognostic Factor ◽

Poor Prognosis ◽

Univariate Analysis ◽

Good Prognosis ◽

Tract Cancer ◽

Node Metastasis ◽

Duodenal Invasion ◽

Duct Cancer ◽

Pancreatic Invasion

333 Background: Ampullay cancer (AC) is relatively good prognosis in the biliary tract cancer. Such as LN metastasis, pancreatic invasion is a prognostic factor in AC. On the other hand, Distal bile duct cancer (DBDC) is somewhat good prognosis in the biliary tract cancer. Such as ductal resection margin positive is a prognostic factor in DBDC. There are few papers considered to both difference. Therefore, we conducted this study to examine the difference of AC and DBDC. Methods: To evaluate Cancer-Specific Survival (CaSS), Recurrence-Free Survival (RFS) and prognostic factors after pancreatoduodenectomy (including pylorus-preserving pancreatoduodenectomy: PPPD, subtotal stomach-preserving pancreatoduodenectomy: SSPPD) based on a series of 80 patients of AC and 36 patients of DBDC from 1996 to 2015. We reviewed and analyzed the clinicopathologic data, recurrence and survival. Results: Five years CaSS and RFS of AC were 72.3% and 72.5%. In univariate analysis, pancreatic invasion, R1or R2 resection, duodenal invasion and lymph node metastasis are significantly poor prognosis. In multivariate analysis, pancreatic invasion and R1or R2 resection are poor prognostic factors (pancreatic invasion, p = 0.0012, hazard ratio (HR) 5.65 [confidence interval (CI) 1.92-19.5 95%], R1or R2 resection, p = 0.0043, HR 6.22 [CI 1.68-40.2 95%]). On the other hand, five years CaSS and RFS of DBDC were 35.8% and 46.8%. In univariate analysis, pancreatic invasion (+) ≥ 5 mm in depth, and duodenal invasion are significantly poor prognosis. In multivariate analysis, duodenal invasion is the only poor prognostic factors (p = 0.0227, HR 2.90 [CI 1.16-7.39 95%]). Conclusions: DBDC is considerable poor prognosis compared with AC. Lymph node metastasis is not prognostic factor depends on D2 LN dissection in AC, than pancreatic invasion. Cancer cells invaded pancreatic parenchyma in AC; pancreatic invasion may be the most important prognostic factor by biology-like pancreatic cancer. Duodenal invasion in DBDC was prognostic factor reflects the degree of development of the cancer beyond pancreatic parenchyma. Further clinicopathological and biological studies are needed to confirm our findings.

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Clinical Research on Tanreqing Injection Treatment of The Acute Lung Injury

Advanced Emergency Medicine ◽

10.18686/aem.v4i3.15 ◽

2015 ◽

Vol 4 (3) ◽

pp. 46

Author(s):

Hua Zhang

Keyword(s):

Acute Lung Injury ◽

Lung Injury ◽

Good Prognosis ◽

Control Group ◽

Blood Gas ◽

Oxygen Inhalation ◽

Treatment Measures ◽

Primary Trauma ◽

Experimental Group ◽

Better Than

Objective: To discuss the clinical effect of Tanreqing injection in treatment of acute lung injury. Methods: 47 patients with acute lung injury in our hospital from January 2009 to February 2014 are selected and randomly divided into two groups. The control group has 24 cases and receives the conventional emergency treatment measures, including establishment of intravenous channel, loop support, oxygen inhalation, antibiotics application and primary trauma treatment, etc. There are 23 cases in experimental group, on the basis of treatment of the control group, they are treated with Tanreqing injection. The two groups are compared after treatment to study the clinical efficiency, blood gas index, SIRS score and the incidence of ARDS. Results: The treatment efficiency of patients with acute lung injury in experimental group is significantly higher than the control group (p < 0.05). After treatment, the blood gas index such as PO2, PCO2, PO2/FiO2 and others and SIRS score of patient with acute lung injury in both groups are obviously improved, and the experimental group is significantly better than the control group (p < 0.05). At the same time, the incidence of ARDS of patients with acute lung injury in the experimental group is significantly lower than the control group (p < 0.05). Conclusion: The use of Tanreqing injection during the treatment of acute lung injury can effectively improve patients’ ventilation and alleviate symptoms of respiratory distress and has good prognosis.

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Prognostic Factors Predicting Poor Outcome in Cancer Patients with Febrile Neutropenia in the Emergency Department: Usefulness of qSOFA

Journal of Oncology ◽

10.1155/2018/2183179 ◽

2018 ◽

Vol 2018 ◽

pp. 1-7 ◽

Cited By ~ 3

Author(s):

Seung Jae Lee ◽

Ji Hye Kim ◽

Seung Baik Han ◽

Jin Hui Paik ◽

Areum Durey

Keyword(s):

Emergency Department ◽

Prognostic Factors ◽

Febrile Neutropenia ◽

Poor Prognosis ◽

Multiple Logistic Regression Analysis ◽

Total Bilirubin Level ◽

Control Group ◽

Case Group ◽

Patients With Cancer ◽

Poor Outcome

Background/Aims. Febrile neutropenia is considered as one of the most important and potentially life-threatening oncologic emergencies, which requires prompt medical assessment and treatment with antibiotics. This was a single-center retrospective study that investigated the prognostic factors predicting poor outcome in patients with cancer who presented with febrile neutropenia at the emergency department (ED). Methods. The medical records of patients diagnosed with febrile neutropenia in the ED from January 2014 to December 2017 were reviewed. Patients aged >18 years who were diagnosed with a malignancy were included in the analysis. Febrile neutropenia was defined as an absolute neutrophil count < 1,000/mm3 with a temperature greater than 38°C. Patients were divided into two groups: those who were admitted at the intensive care unit (ICU) or those who died in the hospital (case group) and those who were admitted at general wards and were discharged (control group). The two groups were compared to determine the factors associated with poor prognosis. Results. We identified 104 patients (25 and 79 from the case and control groups, respectively) with cancer who presented with febrile neutropenia at the ED during the study period. Lower blood pressure, platelet count, and HCO3- level, higher CRP and creatinine level, and the presence of bacteremia were more commonly observed in the case group than in the control group. In the multiple logistic regression analysis, the following independent predictors significantly correlated with ICU admission and in-hospital mortality: quick sequential (sepsis-related) organ failure assessment (qSOFA) score (odds ratio [OR]: 4.62; 95% confidence interval [CI]: 1.17–18.22; p=0.285), hemoglobin level (OR: 0.51; 95% CI: 0.33–0.78; p=0.002), total bilirubin level (OR: 7.69; 95% CI: 1.29–45.8; p=0.025), and respiratory tract infection (OR: 29.65; 95% CI: 3.81–230.7; p=0.0012). Conclusions. The qSOFA can be a useful bedside tool for patients with cancer who present with febrile neutropenia at the ED. Moreover, it can help emergency physicians in identifying patients at risk of poor prognosis and in initiating prompt empirical antimicrobial therapy. Further studies must be conducted to validate the efficacy of the qSOFA in these patients in the ED.

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Prognostic factors of chest CT findings for ICU admission and mortality in patients with COVID-19 pneumonia

10.1101/2020.10.30.20223024 ◽

2020 ◽

Author(s):

Mohammad Ali Kazemi ◽

Hossein Ghanaati ◽

Behnaz Moradi ◽

Mohammadreza Chavoshi ◽

Hassan Hashemi ◽

...

Keyword(s):

Multivariate Analysis ◽

Prognostic Factors ◽

Poor Prognosis ◽

Underlying Disease ◽

Good Prognosis ◽

Chest Ct ◽

Icu Admission ◽

Ct Findings ◽

Pattern Distribution ◽

Ct Features

AbstractBackgroundStudies have shown that CT could be valuable for prognostic issues in COVID-19Objectiveto investigate the prognostic factors of early chest CT findings in COVID-19 patients.Materials and MethodsThis retrospective study included 91 patients (34 women, and 57 men) of RT-PCR positive COVID-19 from 3 hospitals in Iran between February 25, 2020, to march 15, 2020. Patients were divided into two groups as good prognosis, discharged from the hospital and alive without symptoms (48 patients), and poor prognosis, died or needed ICU care (43 patients). The first CT images of both groups that were obtained during the first 8 days of the disease presentation were evaluated considering the pattern, distribution, and underlying disease. The total CT-score was calculated for each patient. Univariate and multivariate analysis with IBM SPSS Statistics v.26 was used to find the prognostic factors.ResultsThere was a significant correlation between poor prognosis and older ages, dyspnea, presence of comorbidities, especially cardiovascular and pulmonary. Considering CT features, peripheral and diffuse distribution, anterior and paracardiac involvement, crazy paving pattern, and pleural effusion were correlated with poor prognosis. There was a correlation between total CT-score and prognosis and an 11.5 score was suggested as a cut-off with 67.4% sensitivity and 68.7% specificity in differentiation of poor prognosis patients (patients who needed ICU admission or died. Multivariate analysis revealed that a model consisting of age, male gender, underlying comorbidity, diffused lesions, total CT-score, and dyspnea would predict the prognosis better.ConclusionTotal chest CT-score and chest CT features can be used as prognostic factors in COVID-19 patients. A multidisciplinary approach would be more accurate in predicting the prognosis.

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Prognostic factors in patients with advanced renal carcinoma.

Journal of Clinical Oncology ◽

10.1200/jco.2011.29.7_suppl.391 ◽

2011 ◽

Vol 29 (7_suppl) ◽

pp. 391-391

Author(s):

C. Muriel ◽

E. Esteban ◽

A. Astudillo ◽

P. Martinez-Camblor ◽

N. Corral ◽

...

Keyword(s):

Prognostic Factors ◽

Prognostic Factor ◽

Retrospective Cohort ◽

Poor Prognosis ◽

Renal Carcinoma ◽

Good Prognosis ◽

Biological Agents ◽

Enhanced Expression ◽

Favorable Prognostic Factor ◽

Low Expression

391 Background: A retrospective cohort of 135 patients with advanced RCC treated with biological agents and/or cytokines (CK) was analysed between July 1996 and February 2010. Methods: The expression of several biomarkers by immunohistochemistry and 2 analytical variables: thrombocytosis and neutrophilia were analysed and were correlated with prognosis. Results: 67 patients were treated only with biological agents and 68 with CK (23 received also biological agents). The univariate statistical analysis showed that the enhanced expression of HIF-1alpha correlated with a poor prognosis in patients treated with sunitinib (PFS was 5.4 vs. 13.4 months in those with low expression, p=0.001). The overexpression of ACIX was associated to a better prognosis in patients that received biological agents (PFS was 18.3 vs. 5.2 months in those with decreased expression, p<0.001; OS was 32.1 vs. 7.8 months, p<0.001), including sunitinib (PFS was 16.8 vs. 5.5 months, p<0.001), sorafenib (PFS was 8 vs 3.5 months, p<0.001)) and CK (PFS was 6.3 vs. 2.7 months, p=0.003; OS was 32.9 vs. 5.9 months, p=0.001). Positive PTEN was related to a good prognosis in patients treated with sunitinib (PFS was 15.1 vs. 6.5 months, p=0.003) and CK (PFS was 7.5 vs. 3.8 months, p=0.037, OS was 13.7 vs 7.9 months, p=0.039). The increased expression of p21 was related to a poor prognosis in patients that received biological agents (PFS was 5.9 vs. 16.8 months with high expression, p=0.024), including sunitinib (PFS was 6.2 vs 18.9 months, p<0.001), sorafenib (PFS was 4 vs 9 months, p=0.013) and CK (PFS was 3.9 vs. 7.5 months, p<0.001). Thrombocytosis was related to a poor prognosis in patients treated with CK (PFS was 2.6 vs. 5.1 months p=0.017; OS was 5.9 vs. 14.3 months p=0.010). Neutrophilia was related to a poor prognosis in patients that received CK (PFS was 2.6 vs. 5.7 months, p=0.019; OS was 5.9 vs. 12.8 months, p=0.035). In the multivariate analysis, the overexpression of ACIX was a favorable prognostic factor independent of PFS with a HR of 0.107 (p<0.001) and OS with a HR of 0.055 (p<0.001). Conclusions: Our experience has suggested the utility of de HIF-1alpha, ACIX, PTEN, p21, thrombocytosis and neutrophilia as prognostic factors in patients with advanced RCC. ACIX has shown to be an independent prognostic factor. No significant financial relationships to disclose.

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Prognostic Factors of Initial Chest CT Findings for ICU Admission and Mortality in Patients with COVID-19 Pneumonia

Iranian Journal of Radiology ◽

10.5812/iranjradiol.106879 ◽

2020 ◽

Vol In Press (In Press) ◽

Author(s):

Mohammad Ali Kazemi ◽

Hossein Ghanaati ◽

Behnaz Moradi ◽

Mohammadreza Chavoshi ◽

Hassan Hashemi ◽

...

Keyword(s):

Multivariate Analysis ◽

Prognostic Factors ◽

Poor Prognosis ◽

Underlying Disease ◽

Good Prognosis ◽

Chest Ct ◽

Icu Admission ◽

Ct Findings ◽

Pattern Distribution ◽

Ct Features

Background: Studies have shown that CT could be valuable for prognostic issues in COVID-19. Objectives: To investigate the prognostic factors of early chest CT findings in COVID-19 patients. Methods: This retrospective study included 91 patients (34 women, and 57 men) of real-time reverse transcription polymerase chain reaction (RT-PCR) positive COVID-19 from three hospitals in Iran between February 25, 2020, to March 15, 2020. Patients were divided into two groups as good prognosis, discharged from the hospital and alive without symptoms (48 patients), and poor prognosis, died or needed ICU care (43 patients). The first CT images of both groups that were obtained during the first 8 days of the disease presentation were evaluated considering the pattern, distribution, and underlying disease. The total CT-score was calculated for each patient. Univariate and multivariate analysis with IBM SPSS Statistics v.26 was used to find the prognostic factors. Results: There was a significant correlation between poor prognosis and older ages, dyspnea, presence of comorbidities, especially cardiovascular and comorbidities. Considering CT features, peripheral and diffuse distribution, anterior and paracardiac involvement, crazy paving pattern, and pleural effusion were correlated with poor prognosis. There was a correlation between total CT-score and prognosis and an 11.5 score was suggested as a cut-off with 67.4% sensitivity and 68.7% specificity in differentiation of poor prognosis patients (patients who needed ICU admission or died). Multivariate analysis revealed that a model consisting of age, male gender, underlying comorbidity, diffused lesions, total CT-score, and dyspnea would predict the prognosis better. Conclusions: Total chest CT-score and chest CT features can be used as prognostic factors in COVID-19 patients. A multidisciplinary approach would be more accurate in predicting the prognosis.

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