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Role of ROX index in the first assessment of COVID-19 patients in the emergency department. | LitMetric

AI Article Synopsis

  • During the COVID-19 outbreak, Emergency Departments experienced overcrowding, prompting the need for a simple tool called the ROX index to help in clinical decision-making regarding patient hospitalization and mortality.
  • A study at Sant'Orsola-Malpighi Hospital in Italy evaluated the ROX index in 554 COVID-19 patients, finding that a ROX index value below 25.7 indicated a higher likelihood of hospitalization, while a value under 22.3 was linked to increased 30-day mortality.
  • Results showed that the ROX index was effective in predicting hospitalization needs, mechanical ventilation requirements, and mortality risk, suggesting its usefulness alongside other clinical assessments.

Article Abstract

During the first outbreak of Coronavirus disease 2019 (COVID-19) Emergency Departments (EDs) were overcrowded. Hence, the need for a rapid and simple tool to support clinical decisions, such as the ROX index (Respiratory rate - OXygenation), defined as the ratio of peripheral oxygen saturation and fraction of inspired oxygen, to respiratory rate. The aim of the study was to evaluate the accuracy of the ROX index in predicting hospitalization and mortality in patients with a diagnosis of COVID-19 in the ED. The secondary outcomes were to assess the number of readmissions and the variations in the ROX index between the first and the second admission. This was an observational prospective monocentric study, carried out in the ED of Sant'Orsola-Malpighi Hospital in Bologna, Italy. Five hundred and fifty-four consecutive patients with COVID-19 were enrolled and the ROX index was calculated. Patients were followed until hospital discharge or death. A ROX index value < 25.7 was associated with hospitalization (area under the curve [AUC] = 0.737, 95% CI 0.696-0.779, p < 0.001). The ROX index < 22.3 was statistically related to higher 30-day mortality (AUC = 0.764, 95% CI 0.708-0.820, p < 0.001). Eight patients were discharged and returned to the ED within the subsequent 7 days, their mean ROX index was 30.3 (6.2; range 21.9-39.4) at the first assessment and 24.6 (5.5; 14.5-29.5) at the second assessment, (p = 0.012). The ROX index, together with laboratory, imaging and clinical findings, correlated with the need for hospital admission, mechanical ventilation and mortality risk in COVID-19 patients.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7917022PMC
http://dx.doi.org/10.1007/s11739-021-02675-2DOI Listing

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