COVID-19 患者胸腔积液的预后相关性--一项德国多中心研究。

IF 1.8 4区医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Clinical Imaging Pub Date : 2024-09-26 DOI:10.1016/j.clinimag.2024.110303

Andreas Michael Bucher , Julia Dietz , Constantin Ehrengut , Lukas Müller , Dominik Schramm , Alena Akinina , Michelle Drechsel , Roman Kloeckner , Malte Sieren , Peter Isfort , Marwin-Jonathan Sähn , Matthias A. Fink , Dorottya Móré , Bohdan Melekh , Felix G. Meinel , Hanna Schön , Matthias Stefan May , Lisa Siegler , Hanna Münzfeld , Richard Ruppel , Alexey Surov

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引用次数: 0

摘要

目的：本研究评估了德国十三个中心的 COVID-19 患者胸腔积液（PE）的预后意义，旨在明确胸腔积液在预测临床结果中的作用：在RACOON项目（COVID-19大流行病放射学合作网络）的这项回顾性分析中，1183名患者（29.3%为女性，70.7%为男性）接受了胸部CT检查以评估胸腔积液。我们调查了 PE 与 30 天死亡率、入住重症监护室和机械通气需求的关系：结果：31.5%的患者被检测出胸腔积液，这与 30 天的死亡率有显著相关性（非存活者为 47.5%，存活者为 27.3%，P 结论：胸腔积液是一种常见的肺部疾病：COVID-19患者中有很大一部分存在胸腔积液，并能独立预测30天死亡率的增加，这凸显了胸腔积液作为预后标志物的价值。无论体积或密度如何，胸腔积液的识别都应成为放射学报告的重点，以指导临床决策。

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The prognostic relevance of pleural effusion in patients with COVID-19 - A German multicenter study

Purpose

This study evaluates the prognostic significance of pleural effusion (PE) in COVID-19 patients across thirteen centers in Germany, aiming to clarify its role in predicting clinical outcomes.

Methods

In this retrospective analysis within the RACOON project (Radiological Cooperative Network of the COVID-19 pandemic), 1183 patients (29.3 % women, 70.7 % men) underwent chest CT to assess PE. We investigated PE's association with 30-day mortality, ICU admission, and the need for mechanical ventilation.

Results

PE was detected in 31.5 % of patients, showing a significant correlation with 30-day mortality (47.5 % in non-survivors vs. 27.3 % in survivors, p < 0.001), with a hazard ratio of 2.22 (95 % CI 1.65–2.99, p < 0.001). No significant association was found between PE volume or density and mortality. ICU admissions were noted in 46.8 % of patients, while mechanical ventilation was required for 26.7 %.

Conclusion

Pleural effusion is present in a significant portion of COVID-19 patients and independently predicts increased 30-day mortality, underscoring its value as a prognostic marker. Its identification, irrespective of volume or density, should be a priority in radiological reports to guide clinical decision-making.

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来源期刊

Clinical Imaging 医学-核医学

CiteScore

4.60

自引率

0.00%

发文量

265

审稿时长

35 days

期刊介绍： The mission of Clinical Imaging is to publish, in a timely manner, the very best radiology research from the United States and around the world with special attention to the impact of medical imaging on patient care. The journal''s publications cover all imaging modalities, radiology issues related to patients, policy and practice improvements, and clinically-oriented imaging physics and informatics. The journal is a valuable resource for practicing radiologists, radiologists-in-training and other clinicians with an interest in imaging. Papers are carefully peer-reviewed and selected by our experienced subject editors who are leading experts spanning the range of imaging sub-specialties, which include: -Body Imaging- Breast Imaging- Cardiothoracic Imaging- Imaging Physics and Informatics- Molecular Imaging and Nuclear Medicine- Musculoskeletal and Emergency Imaging- Neuroradiology- Practice, Policy & Education- Pediatric Imaging- Vascular and Interventional Radiology