Predictive tools for acute deterioration in COVID-19 and beyond最新文献

{"title":"S17 Dynamic early warning score versus national early warning score-2 for predicting clinical deterioration in respiratory patients","authors":"S. Gonem, A. Taylor, G. Figueredo, S. Forster, T. Mckeever, J. Garibaldi, D. Shaw","doi":"10.1136/thorax-2021-btsabstracts.23","DOIUrl":"https://doi.org/10.1136/thorax-2021-btsabstracts.23","url":null,"abstract":"S19 Figure 1 SOARS and 4C mortality score in PREDICT and ISARIC cohorts Spoken sessions A16 Thorax 2021;76(Suppl 2):A1–A205 on N ovem er 8, 2021 by gest. P rocted by coright. httphorax.bm jcom / T hrax: frst pulished as 10.113orax-2021-B T S absacts.24 on 8 N ovem er 221. D ow nladed fom","PeriodicalId":288005,"journal":{"name":"Predictive tools for acute deterioration in COVID-19 and beyond","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115885348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"S19 Relevance of prediction scores derived from the SARS-CoV-2 first wave, in the UK COVID-19 second wave, for early discharge, severity and mortality: a PREDICT COVID UK prospective observational cohort study","authors":"H. Ghani, A. Navarra, E. Croft, H. Nur, M. Prabhakar, A. Azri Yahaya, I. Darwish, D. Longe, HL Lee, R. Vancheeswaran","doi":"10.1136/thorax-2021-btsabstracts.25","DOIUrl":"https://doi.org/10.1136/thorax-2021-btsabstracts.25","url":null,"abstract":"S19 Figure 1 SOARS and 4C mortality score in PREDICT and ISARIC cohorts Spoken sessions A16 Thorax 2021;76(Suppl 2):A1–A205 on N ovem er 2, 2021 by gest. P rocted by coright. httphorax.bm jcom / T hrax: frst pulished as 10.113orax-2021-B T S absacts.25 on 8 N ovem er 221. D ow nladed fom in the PREDICT cohort and 9.5% in the ISARIC cohort were admitted despite SOARS score of 0–1. Conclusion SOARS and 4C Mortality Score remains valid and relevant to their purpose, transforming complex clinical presentations into tangible numbers, aiding objective decision making, despite evolving viral subtype and treatment advances altering patient demographic and mortality. More importantly both scores are easily implemented within urgent care pathways for safe admission avoidance especially to a VH model. The new normal? Novel and remote strategies for pulmonary rehabilitation S20 COMBINING PHYSICAL ACTIVITY BEHAVIOURAL MODIFICATION STRATEGIES ALONGSIDE COGNITIVE BEHAVIOURAL THERAPY DURING PULMONARY REHABILITATION IN PATIENTS WITH COPD: AN INTERIM ANALYSIS OF A PILOT RCT M Armstrong, E Hume, L McNeillie, F Chambers, L Wakenshaw, G Burns, K HeslopMarshall, I Vogiatzis. Northumbria University, Newcastle upon Tyne, UK; Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK 10.1136/thorax-2021-BTSabstracts.26 Introduction In patients with COPD, pulmonary rehabilitation (PR) improves exercise capacity, but continues to report inconsistent improvements in physical activity, particularly in those with low baseline physical activity levels. In addition, patients with elevated levels of anxiety and/or depression are typically less able to manage symptoms and improve physical activity. Objective To determine the efficacy of combining physical activity behavioural modification strategies (PA) with cognitive behavioural therapy (CBT) during PR in improving patients’ experiences of physical activity and steps/day in COPD patients with low baseline physical activity levels and high anxiety and/or depression. Methods In this pilot RCT, 23 patients (mean±SD: FEV1: 40 ±17%, baseline steps/day: 2913±1821, HADS Anxiety: 11±3, HADS Depression: 11±4) were assigned 1:1 to receive PR +CBT, or PA (comprising motivational interviews, step count monitoring, feedback using a pedometer and goal setting) alongside PR+CBT (PA+PR+CBT). Assessments included patients’ experiences of the amount and difficulty of physical activity captured by the Clinical PROactive Physical Activity in COPD (C-PPAC) instrument, accelerometer steps/day, the 6MWT, CAT and HADS questionnaires. Results We found significant and clinically important improvements in favour of PA+PR+CBT compared to PR+CBT intervention in the C-PPAC total score and steps/day. Meanwhile, similar significant and clinically important improvements in the 6MWT, CAT and HADS depression scores were reported across both groups (table 1). Conclusions Providing anxious and/or depressed patients with physical activity behaviour","PeriodicalId":288005,"journal":{"name":"Predictive tools for acute deterioration in COVID-19 and beyond","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115490998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"S16 Prognostication in hospital acquired pneumonia – are current scoring systems fit for purpose?","authors":"A. Adiga, F. Grudzinska, D. Dosanjh, D. Parekh","doi":"10.1136/thorax-2021-btsabstracts.22","DOIUrl":"https://doi.org/10.1136/thorax-2021-btsabstracts.22","url":null,"abstract":"","PeriodicalId":288005,"journal":{"name":"Predictive tools for acute deterioration in COVID-19 and beyond","volume":"2011 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129142275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"S18 Investigating the impact of influenza activity on excess mortality rates from cardiovascular, respiratory and renal diseases in Ireland during the 2010/11–2019/20 influenza seasons","authors":"Jxm Choo, J. Harbison","doi":"10.1136/thorax-2021-btsabstracts.24","DOIUrl":"https://doi.org/10.1136/thorax-2021-btsabstracts.24","url":null,"abstract":"IntroductionCOVID-19 and influenza infection are associated with cardiovascular, respiratory and renal complications. However, cardiovascular, respiratory and renal disease mortality rates in Ireland decreased by 0.04%, 0.12% and 0.12% respectively in 2020 relative to 2019, despite nearly 100,000 new COVID-19 cases being reported in Ireland in 2020. Government-imposed social distancing measures resulted in abolition of influenza activity (IA). We analysed population data from the 2010/11–2019/20 influenza seasons to estimate the impact of reduced IA on cardiovascular, respiratory and renal disease mortality rates during the COVID-19 pandemic season.MethodsQuarterly mortality data for acute myocardial infarction (AMI), cerebrovascular disease, pneumonia, asthma and renal disease from first quarter (Q1) 2010 to fourth quarter (Q4) 2020 was obtained from the Central Statistics Office. Weekly data on influenza-like illness (ILI) rates and positive percentages (PP) (i.e., proportion of influenza-positive sentinel respiratory specimens) was obtained from the Health Protection Surveillance Centre. Excess mortality rate during influenza season was defined as the percentage difference between Q4/Q1 and preceding third quarter (Q3) mortality rates. We adopted the Goldstein Index (ILI rate × PP) as an indicator of IA. Time series analyses, Pearson correlation coefficients (r) and linear regression models were used to evaluate the relationships between IA and excess cardiovascular, respiratory and renal disease mortality rates.ResultsStatistically significant positive associations were observed between IA and excess AMI (r=0.557, p=0.011), cerebrovascular disease (r=0.858, p<0.001), pneumonia (r=0.635, p=0.003), asthma (r=0.668, p=0.001) and renal disease (r=0.652, p=0.002) mortality rates. Linear regression models predicted 0.072% (95% confidence interval 0.019%, 0.125%), 0.095% (0.067%, 0.123%), 0.184% (0.073%, 0.296%), 0.367% (0.165%, 0.569%) and 0.124% (0.053%, 0.196%) increases in excess AMI, cerebrovascular disease, pneumonia, asthma and renal disease mortality rates respectively per unit increase in IA.ConclusionElimination of IA may have contributed towards limiting the effects of COVID-19 on cardiovascular, respiratory and renal disease mortality rates in Ireland.","PeriodicalId":288005,"journal":{"name":"Predictive tools for acute deterioration in COVID-19 and beyond","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126048768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}