Evaluation of Reliability and Validity of the RALE and BRIXIA Chest-X Ray Scores in Patients Hospitalized with COVID-19 Pneumonia.

IF 1.6 Q2 MEDICINE, GENERAL & INTERNAL Romanian Journal of Internal Medicine Pub Date : 2023-09-01 DOI:10.2478/rjim-2023-0013
Themistoklis Paraskevas, Platon M Dimopoulos, Anastasios Kantanis, Anna-Sofia Garatzioti, Iosif Karalis, Christos Michailides, Charikleia Chourpiliadi, Evgenia Matthaiakaki, Christina Kalogeropoulou, Dimitrios Velissaris
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Abstract

Introduction: Chest X-rays are commonly used to assess the severity in patients that present in the emergency department with suspected COVID-19 pneumonia, but in clinical practice quantitative scales are rarely employed.

Aims: To evaluate the reliability and validity of two semi-quantitative radiological scales in patients hospitalized for COVID-19 pneumonia (BRIXIA score and RALE score).

Methods: Patients hospitalized between October 2021 and March 2022 with confirmed COVID-19 pneumonia diagnosis were eligible for inclusion. All included patients had a chest X-ray taken in the ED before admission. Three raters that participated in the treatment and management of patients with COVID-19 during the pandemic independently assessed chest X-rays.

Results: Intraclass coefficients for BRIXΙA and RALES was 0.781 (0.729-0.826) and 0.825 (0.781-0.862) respectively, showing good to excellent reliability overall. Pairwise analysis was performed using quadratic weighted kappa showing significant variability in the inter-rater agreement. The prognostic accuracy of the two scores for in-hospital mortality for all raters was between 0.753 and 0.763 for BRIXIA and 0.737 and 0.790 for RALES, demonstrating good to excellent prognostic value. Both radiological scores were significantly associated with inhospital mortality after adjustment for 4C Mortality score. We found a consistent upwards trend with significant differences between severity groups in both radiological scores.

Conclusion: Our findings suggest that BRIXIA and RALES are reliable and can be used to assess the prognosis of patients with COVID-19 requiring hospitalization. However, the inherent subjectivity of radiological scores might make it difficult to set a cut-off value suitable for all assessors.

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新型冠状病毒肺炎住院患者RALE和BRIXIA胸片评分信效度评价
简介:胸片通常用于评估急诊疑似COVID-19肺炎患者的严重程度,但在临床实践中很少使用定量量表。目的:评价两种半定量放射学量表(BRIXIA评分和RALE评分)在COVID-19肺炎住院患者中的信度和效度。方法:纳入2021年10月至2022年3月住院并确诊为COVID-19肺炎的患者。所有患者在入院前都在急诊科拍过胸部x光片。在大流行期间参与COVID-19患者治疗和管理的三名评分员独立评估胸部x光片。结果:BRIXΙA和RALES的类内系数分别为0.781(0.729-0.826)和0.825(0.781-0.862),总体信度为良至优。两两分析使用二次加权kappa显示显着变异性之间的协议。BRIXIA和RALES两项评分对院内死亡率的预测准确率分别为0.753 ~ 0.763和0.737 ~ 0.790,具有良好至极好的预后价值。调整4C死亡率评分后,两种放射学评分均与住院死亡率显著相关。我们发现严重程度组在两种放射学评分上有显著差异的持续上升趋势。结论:我们的研究结果表明,BRIXIA和RALES是可靠的,可用于评估COVID-19住院患者的预后。然而,放射学评分固有的主观性可能使其难以设定一个适用于所有评估者的临界值。
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来源期刊
Romanian Journal of Internal Medicine
Romanian Journal of Internal Medicine MEDICINE, GENERAL & INTERNAL-
CiteScore
3.20
自引率
5.30%
发文量
35
审稿时长
15 weeks
期刊介绍: Romanian Journal of Physics is a journal publishing physics contributions on the following themes: •Theoretical Physics & Applied Mathematics •Nuclear Physics •Solid State Physics & Materials Science •Statistical Physics & Quantum Mechanics •Optics •Spectroscopy •Plasma & Lasers •Nuclear & Elementary Particles Physics •Atomic and Molecular Physics •Astrophysics •Atmosphere and Earth Science •Environment Protection
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