目的：探讨计算机辅助诊断技术（CAD）对张家界市重型与危重型Omicron感染者的临床意义,为重型与危重型Omicron感染者的救治工作提供更多的参考依据。方法：收集了2022年12月―2023年1月在张家界市人民医院住院治疗的重型与危重型Omicron感染者的一般资料、qSOFA评分、实验室检查、肺部CT等,将肺部CT使用CAD技术进行分割与重建,输出炎症占比,比较重型与危重型患者间临床特征与炎症占比有无差异,并探讨炎症占比与疾病分型之间的关系。结果：共有116名重型、危重型患者被纳入本项研究,年龄中位数73.0（65.0,84.0）岁,60.3%（n=70）的患者入住ICU,86.2%（n=100）患者合并有基础疾病。相比于重型患者,危重型患者有着更高的炎症占比、qSOFA评分、C-反应蛋白、D-二聚体等（P<0.05）。炎症占比越高,疾病进展为危重型的可能性越大（r=0.24,P=0.009）,炎症占比在判断病情进展为危重型时的灵敏度、特异度、准确度分别为0.656、0.745、0.638,截断值为31.46%。结论：CAD对于重症COVID-19肺炎患者病情评估有一定的价值,炎症占比越高,疾病进展为危重型的可能性越大,当肺部炎症占比≥31.46%时,患者极有可能进展为危重型。
Abstract
Objective The purpose of this study is to investigate the clinical significance of computer-aided diagnosis (CAD) in patients with severe and critically-severe Omicron infections in Zhangjiajie. The study aims to provide additional references for the treatment of these patients. Method From December 2022 to January 2023, we collected various clinical data such as qSOFA score, laboratory test results, and lung CT scans from patients who were hospitalized with severe and critically-severe Omicron infections. Additionally, in this study, we utilized computer-aided diagnosis to segment and reconstruct the lung CT, enabling us to accurately calculate the proportion of inflammation. Our objective was to compare the clinical characteristics and inflammation proportion of severe and critically-severe, with the aim of identifying any potential differences and exploring the relationship between inflammation proportion and critical illness. Results A total of 116 severe and critically-severe patients were included in this study, The median age of the patients was 73.0(ranging from 65.0 to 84.0) years, and 60.3% (n=70) of patients were admitted to the ICU. Among the patients, 86.2% (n=100) patients had underlying diseases. proportion of inflammation, qSOFA score, C-reactive protein, and D-dimer were higher in critically-severe patients than in severe patients (P<0.05). The higher the proportion of inflammation, the easier it is to develop critical illness (r=0.24, P=0.009). The sensitivity, specificity and accuracy of inflammation proportion in the diagnosis of progress to critically-severe were 0.656, 0.745 and 0.638, the cutoff value was 31.46%. Conclusion Computer-aided diagnosis has a certain value in evaluating the condition of patients with severe COVID-19 pneumonia. The higher the proportion of inflammation, the greater the possibility of the disease progressing to critical illness, it is hypothesized that if the proportion of lung inflammation is equal to or greater than 31.46%, the patient is at a high risk of progressing to critical illness.
关键词
重症COVID-19肺炎 /
Omicron毒株 /
计算机辅助诊断技术 /
炎症占比 /
临床特征
Key words
severe COVID-19 pneumonia /
Omicron strain /
computer-aided diagnosis /
proportion of inflammation /
clinical characteristics
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基金
张家界市科技发展重点专项项目（202201）; 张家界市永定区科技创新计划项目（202216）
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