tetano
Editor, Senior Moderator
Hepatol Commun
. 2021 Sep;5(9):1605-1615.
doi: 10.1002/hep4.1737. Epub 2021 Jul 16.
Fibrosis-4 Predicts the Need for Mechanical Ventilation in a National Multiethnic Cohort of Corona Virus Disease 2019
Richard K Sterling[SUP] 1 [/SUP], Dongho Shin[SUP] 2 [/SUP], Yongyun Shin[SUP] 2 [/SUP], Evan French[SUP] 3 [/SUP], Michael P Stevens[SUP] 4 [/SUP], Jasmohan S Bajaj[SUP] 1 [/SUP], Marjolein DeWit[SUP] 5 [/SUP], Arun J Sanyal[SUP] 1 [/SUP]
Affiliations
Abstract
Simple tests of routine data are needed for those with severe acute respiratory syndrome coronavirus 2, which causes corona virus disease 2019 (COVID-19), to help identify those who may need mechanical ventilation (MV). In this study, we aimed to determine if fibrosis-4 (FIB-4) is associated with the need for MV in patients with COVID-19 and if there is an association to determine the optimal FIB-4 cutoff. This was a retrospective, national, multiethnic cohort study of adults seen in an ambulatory or emergency department setting who were diagnosed with COVID-19. We used the TriNetX platform for analysis. Measures included demographics, comorbid diseases, and routine laboratory tests. A total of 4,901 patients with COVID-19 were included. Patients had a mean age of 56, 48% were women, 42% were obese, 38% were white, 40% were black, 15% had cardiac disease, 39% had diabetes mellitus, 20% had liver disease, and 50% had respiratory disease. The need for MV was 6%. The optimal FIB-4 cutoff for the need for MV was 3.04 (area under the curve, 0.735), which had sensitivity, specificity, and positive and negative predictive values of 42%, 77%, 11%, and 95%, respectively, with 93% accuracy. When stratified by race, increased FIB-4 remained associated with the need for MV in both white and black patients. Conclusion: FIB-4 can be used by frontline providers to identify patients that may require MV.
. 2021 Sep;5(9):1605-1615.
doi: 10.1002/hep4.1737. Epub 2021 Jul 16.
Fibrosis-4 Predicts the Need for Mechanical Ventilation in a National Multiethnic Cohort of Corona Virus Disease 2019
Richard K Sterling[SUP] 1 [/SUP], Dongho Shin[SUP] 2 [/SUP], Yongyun Shin[SUP] 2 [/SUP], Evan French[SUP] 3 [/SUP], Michael P Stevens[SUP] 4 [/SUP], Jasmohan S Bajaj[SUP] 1 [/SUP], Marjolein DeWit[SUP] 5 [/SUP], Arun J Sanyal[SUP] 1 [/SUP]
Affiliations
- PMID: 34510829
- DOI: 10.1002/hep4.1737
Abstract
Simple tests of routine data are needed for those with severe acute respiratory syndrome coronavirus 2, which causes corona virus disease 2019 (COVID-19), to help identify those who may need mechanical ventilation (MV). In this study, we aimed to determine if fibrosis-4 (FIB-4) is associated with the need for MV in patients with COVID-19 and if there is an association to determine the optimal FIB-4 cutoff. This was a retrospective, national, multiethnic cohort study of adults seen in an ambulatory or emergency department setting who were diagnosed with COVID-19. We used the TriNetX platform for analysis. Measures included demographics, comorbid diseases, and routine laboratory tests. A total of 4,901 patients with COVID-19 were included. Patients had a mean age of 56, 48% were women, 42% were obese, 38% were white, 40% were black, 15% had cardiac disease, 39% had diabetes mellitus, 20% had liver disease, and 50% had respiratory disease. The need for MV was 6%. The optimal FIB-4 cutoff for the need for MV was 3.04 (area under the curve, 0.735), which had sensitivity, specificity, and positive and negative predictive values of 42%, 77%, 11%, and 95%, respectively, with 93% accuracy. When stratified by race, increased FIB-4 remained associated with the need for MV in both white and black patients. Conclusion: FIB-4 can be used by frontline providers to identify patients that may require MV.