P-33 COMBINATION OF FIB-4 SCORE AND D-DIMER TO PREDICT OUTCOME IN HOSPITALIZED COVID-19 PATIENTS
Conflict of interest: No Introduction and Objectives: Identifying risk factors for poor outcomes is crucial for defining treatment strategies and allocating resources in COVID-19. The Fibrose-4 score (FIB-4) and D-dimer (DD) have emerged as prognostic markers; however, precise cutoff points and thei...
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| Format: | Article |
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Elsevier
2024-12-01
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| Series: | Annals of Hepatology |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1665268124004307 |
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| author | Fernanda Pozzobon Manhães Maria Chiara Chindamo Renata Perez de Mello Ronir Luiz Raggio Maria Paula Cunha Fontes Raymundo Julia Parente Gomes Taisa Garilha Melo |
| author_facet | Fernanda Pozzobon Manhães Maria Chiara Chindamo Renata Perez de Mello Ronir Luiz Raggio Maria Paula Cunha Fontes Raymundo Julia Parente Gomes Taisa Garilha Melo |
| author_sort | Fernanda Pozzobon Manhães |
| collection | DOAJ |
| description | Conflict of interest: No Introduction and Objectives: Identifying risk factors for poor outcomes is crucial for defining treatment strategies and allocating resources in COVID-19. The Fibrose-4 score (FIB-4) and D-dimer (DD) have emerged as prognostic markers; however, precise cutoff points and their combined use remain unstudied. Objectives: This study aimed to compare the individual and combined performance of FIB-4 and DD in predicting outcomes among COVID-19 patients. Patients / Materials and Methods: Materials and Methods: From March to December/2020, hospitalized COVID-19 patients were evaluated regarding laboratory admission tests, chest CT scan, gender, age, lung involvement, ICU admission, hemodialysis, mechanical ventilation, and mortality. Optimal FIB-4 and DD cutoffs to predict in-hospital mortality, aiming to maximize sensitivity and specificity, were established. A sequential diagnostic strategy using both markers was subsequently evaluated. Results and Discussion: Results and Discussion: Among 518 patients (61±16 years, 64% men), the in-hospital mortality rate was 18%. FIB-4 showed superior performance in predicting mortality compared to DD (AUROC 0.76 vs. 0.65, p=0.003) and was chosen as the first step in sequential analysis. Mortality was higher in patients with FIB-4≥1.76 vs. FIB-4<1.76 (26% vs. 5%, p<0.001) and DD≥2000 ng/mL FEU vs. DD<2000 ng/mL FEU (38% vs. 16%, p<0.001). FIB-4 was used as a screening test, with a cutoff point of 1.76 (90% sensitivity in ROC curve analysis), followed by DD measurement with a cutoff value of 2000 ng/mL FEU (specificity of 90%). Through this approach, a subgroup of patients with a higher mortality rate was identified, compared to the use of FIB-4 alone (48% vs. 26%, p<0.001), missing the identification of only 4.7% of deaths. Conclusions: The sequential use of FIB-4 and DD represents a comprehensive strategy to identify high-risk COVID-19 patients at hospital admission, potentially minimizing unnecessary DD assessments in patients initially classified by FIB-4 as low-risk for adverse outcomes. |
| format | Article |
| id | doaj-art-d4e48a9889724087bcdcab6ff28c0765 |
| institution | Kabale University |
| issn | 1665-2681 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Annals of Hepatology |
| spelling | doaj-art-d4e48a9889724087bcdcab6ff28c07652024-12-07T08:25:32ZengElsevierAnnals of Hepatology1665-26812024-12-0129101647P-33 COMBINATION OF FIB-4 SCORE AND D-DIMER TO PREDICT OUTCOME IN HOSPITALIZED COVID-19 PATIENTSFernanda Pozzobon Manhães0Maria Chiara Chindamo1Renata Perez de Mello2Ronir Luiz Raggio3Maria Paula Cunha Fontes Raymundo4Julia Parente Gomes5Taisa Garilha Melo6Hospital Barra Dor/IDOR, Rio de Janeiro, BrasilHOSPITAL BARRA DOR, Rio de Janeiro, BrasilUFRJ, Rio de Janeiro, BrasilUFRJ, Rio de Janeiro, BrasilREDE D'OR SÃO LUIS, Rio de Janeiro, BrasilREDE D'OR SÃO LUIS, Rio de Janeiro, BrasilREDE D'OR SÃO LUIS, Rio de Janeiro, BrasilConflict of interest: No Introduction and Objectives: Identifying risk factors for poor outcomes is crucial for defining treatment strategies and allocating resources in COVID-19. The Fibrose-4 score (FIB-4) and D-dimer (DD) have emerged as prognostic markers; however, precise cutoff points and their combined use remain unstudied. Objectives: This study aimed to compare the individual and combined performance of FIB-4 and DD in predicting outcomes among COVID-19 patients. Patients / Materials and Methods: Materials and Methods: From March to December/2020, hospitalized COVID-19 patients were evaluated regarding laboratory admission tests, chest CT scan, gender, age, lung involvement, ICU admission, hemodialysis, mechanical ventilation, and mortality. Optimal FIB-4 and DD cutoffs to predict in-hospital mortality, aiming to maximize sensitivity and specificity, were established. A sequential diagnostic strategy using both markers was subsequently evaluated. Results and Discussion: Results and Discussion: Among 518 patients (61±16 years, 64% men), the in-hospital mortality rate was 18%. FIB-4 showed superior performance in predicting mortality compared to DD (AUROC 0.76 vs. 0.65, p=0.003) and was chosen as the first step in sequential analysis. Mortality was higher in patients with FIB-4≥1.76 vs. FIB-4<1.76 (26% vs. 5%, p<0.001) and DD≥2000 ng/mL FEU vs. DD<2000 ng/mL FEU (38% vs. 16%, p<0.001). FIB-4 was used as a screening test, with a cutoff point of 1.76 (90% sensitivity in ROC curve analysis), followed by DD measurement with a cutoff value of 2000 ng/mL FEU (specificity of 90%). Through this approach, a subgroup of patients with a higher mortality rate was identified, compared to the use of FIB-4 alone (48% vs. 26%, p<0.001), missing the identification of only 4.7% of deaths. Conclusions: The sequential use of FIB-4 and DD represents a comprehensive strategy to identify high-risk COVID-19 patients at hospital admission, potentially minimizing unnecessary DD assessments in patients initially classified by FIB-4 as low-risk for adverse outcomes.http://www.sciencedirect.com/science/article/pii/S1665268124004307 |
| spellingShingle | Fernanda Pozzobon Manhães Maria Chiara Chindamo Renata Perez de Mello Ronir Luiz Raggio Maria Paula Cunha Fontes Raymundo Julia Parente Gomes Taisa Garilha Melo P-33 COMBINATION OF FIB-4 SCORE AND D-DIMER TO PREDICT OUTCOME IN HOSPITALIZED COVID-19 PATIENTS Annals of Hepatology |
| title | P-33 COMBINATION OF FIB-4 SCORE AND D-DIMER TO PREDICT OUTCOME IN HOSPITALIZED COVID-19 PATIENTS |
| title_full | P-33 COMBINATION OF FIB-4 SCORE AND D-DIMER TO PREDICT OUTCOME IN HOSPITALIZED COVID-19 PATIENTS |
| title_fullStr | P-33 COMBINATION OF FIB-4 SCORE AND D-DIMER TO PREDICT OUTCOME IN HOSPITALIZED COVID-19 PATIENTS |
| title_full_unstemmed | P-33 COMBINATION OF FIB-4 SCORE AND D-DIMER TO PREDICT OUTCOME IN HOSPITALIZED COVID-19 PATIENTS |
| title_short | P-33 COMBINATION OF FIB-4 SCORE AND D-DIMER TO PREDICT OUTCOME IN HOSPITALIZED COVID-19 PATIENTS |
| title_sort | p 33 combination of fib 4 score and d dimer to predict outcome in hospitalized covid 19 patients |
| url | http://www.sciencedirect.com/science/article/pii/S1665268124004307 |
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