Show simple item record

Files in this item

Thumbnail

Item metadata

dc.contributor.authorLiu, Alexander Qichen
dc.contributor.authorHammond, Robert
dc.contributor.authorChan, Kenneth
dc.contributor.authorChukwuenweniwe, Chukwugozie
dc.contributor.authorJohnson, Rebecca
dc.contributor.authorKhair, Duaa
dc.contributor.authorDuck, Eleanor
dc.contributor.authorOlubodun, Oluwaseun
dc.contributor.authorBarwick, Kirstian
dc.contributor.authorBanya, Winston
dc.contributor.authorStirrup, James
dc.contributor.authorDonnelly, Peter Duncan
dc.contributor.authorKaski, Juan Carlos
dc.contributor.authorCoates, Anthony R M
dc.date.accessioned2023-08-30T10:30:14Z
dc.date.available2023-08-30T10:30:14Z
dc.date.issued2023-08-30
dc.identifier293053342
dc.identifier81a8d490-2965-48fc-9013-2220f847a081
dc.identifier85172933062
dc.identifier.citationLiu , A Q , Hammond , R , Chan , K , Chukwuenweniwe , C , Johnson , R , Khair , D , Duck , E , Olubodun , O , Barwick , K , Banya , W , Stirrup , J , Donnelly , P D , Kaski , J C & Coates , A R M 2023 , ' Low CRB-65 scores effectively rule out adverse clinical outcomes in COVID-19 irrespective of chest radiographic abnormalities ' , Biomedicines , vol. 11 , no. 9 , 2423 . https://doi.org/10.3390/biomedicines11092423en
dc.identifier.issn2227-9059
dc.identifier.otherRIS: urn:7E7FBB6BB75DA9448B41AA7368955999
dc.identifier.urihttps://hdl.handle.net/10023/28261
dc.description.abstractBackground: CRB-65 ( C onfusion; R espiratory rate ≥ 30/min; B lood pressure ≤ 90/60 mmHg; age ≥ 65 years) is a risk score for prognosticating patients with COVID-19 pneumonia. However, a significant proportion of COVID-19 patients have normal chest X-rays (CXRs). The influence of CXR abnormalities on the prognostic value of CRB-65 is unknown, limiting its wider applicability. Methods: We assessed the influence of CXR abnormalities on the prognostic value of CRB-65 in COVID-19. Results: In 589 study patients (71 years (IQR: 57–83); 57% males), 186 (32%) had normal CXRs. On ROC analysis, CRB-65 performed similarly in patients with normal vs. abnormal CXRs for predicting inpatient mortality (AUC 0.67 ± 0.05 vs. 0.69 ± 0.03). In patients with normal CXRs, a CRB-65 of 0 ruled out mortality, NIV requirement and critical illness (intubation and/or ICU admission) with negative predictive values (NPVs) of 94%, 98% and 99%, respectively. In patients with abnormal CXRs, a CRB-65 of 0 ruled out the same endpoints with NPVs of 91%, 83% and 86%, respectively. Patients with low CRB-65 scores had better inpatient survival than patients with high CRB-65 scores, irrespective of CXR abnormalities (all p < 0.05). Conclusions: CRB-65, CXR and CRP are independent predictors of mortality in COVID-19. Adding CXR findings (dichotomised to either normal or abnormal) to CRB-65 does not improve its prognostic accuracy. A low CRB-65 score of 0 may be a good rule-out test for adverse clinical outcomes in COVID-19 patients with normal or abnormal CXRs, which deserves prospective validation.
dc.format.extent1567996
dc.language.isoeng
dc.relation.ispartofBiomedicinesen
dc.subjectCoronavirus disease 2019en
dc.subjectCRB-65en
dc.subjectChest X-rayen
dc.subjectDiagnostic performanceen
dc.subjectInflammatory markersen
dc.subjectPrognosisen
dc.subjectRisk stratificationen
dc.subjectCOVID-19en
dc.subjectRA0421 Public health. Hygiene. Preventive Medicineen
dc.subjectE-NDASen
dc.subject.lccRA0421en
dc.titleLow CRB-65 scores effectively rule out adverse clinical outcomes in COVID-19 irrespective of chest radiographic abnormalitiesen
dc.typeJournal articleen
dc.contributor.institutionUniversity of St Andrews. School of Medicineen
dc.contributor.institutionUniversity of St Andrews. Infection and Global Health Divisionen
dc.identifier.doi10.3390/biomedicines11092423
dc.description.statusPeer revieweden
dc.identifier.urlhttps://www.mdpi.com/2227-9059/11/9/2423en


This item appears in the following Collection(s)

Show simple item record