Does radiographic evaluation pulmonary edema score predict intensive care admission in COVID-19 patients presenting to the emergency department? A retrospective single-center observational study

Authors : Hilal SİPAHİOĞLU, Ali YEŞİLTE, Mine ALTINKAYA ÇAVUŞ, Ayşe KIRIŞ, Ahmet SAVRANLAR

Pages : 1682-1687

Doi:10.32322/jhsm.1180896

View : 14 | Download : 7

Publication Date : 2022-10-25

Article Type : Research Paper

Abstract :Aim: COVID-19 disease can progress from pneumonia to acute respiratory distress syndrome insert ignore into journalissuearticles values(ARDS);. Performing computed tomography on all patients is expensive and exposes them to high radiation. The simple and reproducible Radiographic Evaluation Pulmonary Edema insert ignore into journalissuearticles values(RALE); score, used in ARDS and acute pulmonary edema in the emergency department, can predict the severity of the disease in COVID-19 patients. Material and Method: In our study, a total of 221 COVID-19 patients we followed up between July-November, 2021 were evaluated retrospectively. The patients were divided into two as Intensive care hospitalization and no intensive care hospitalization. Results: Ninety-five insert ignore into journalissuearticles values(43%); patients were admitted to the intensive care unit. The mean age insert ignore into journalissuearticles values(p<.001);, white blood cell count insert ignore into journalissuearticles values(WBC); insert ignore into journalissuearticles values(p=.001);, neutrophil count insert ignore into journalissuearticles values(p<.001);, RALE score, and the number of hospitalization days of the patients admitted to the intensive care unit were higher insert ignore into journalissuearticles values(p<.001);. These findings were positively correlated with the RALE score insert ignore into journalissuearticles values(p<.001);. Age insert ignore into journalissuearticles values(p<.001);, RALE score insert ignore into journalissuearticles values(p=.022);, WBC insert ignore into journalissuearticles values(p=.029);, and neutrophil count insert ignore into journalissuearticles values(p=.004); were independent risk factors in the multivariate analysis of factors affecting intensive care admission. RALE score cut-off value in predicting intensive care unit admission was ≥10.5. In the analysis with an Area Under the Curve value of 0.716, the application of this threshold resulted in a sensitivity of 67.4% and a specificity of 69.8%. Conclusion: In conclusion, performing chest computed tomography in all patients admitted to the emergency department with COVID-19 disease increases the cost and exposure to radiation. The simple and recalculated RALE score can be used to predict intensive care admission in COVID-19 pneumonia.
Keywords : COVID 19, RALE, intensive care unit, emergency department