Imperial College London
Alternate

Claire L. Shovlin PhD FRCP

Faculty of Medicine, National Heart & Lung Institute

Professor of Practice (Clinical and Molecular Medicine)
 
 
 
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Contact

 

c.shovlin Website

 
 
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Location

 

534Block L Hammersmith HospitalHammersmith Campus

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Summary

 

Publications

Citation

BibTex format

@article{Vizcaychipi:2020:10.1016/j.bjid.2020.07.010,
author = {Vizcaychipi, MP and Shovlin, CL and McCarthy, A and Godfrey, A and Patel, S and Shah, PL and Hayes, M and Keays, RT and Beveridge, I},
doi = {10.1016/j.bjid.2020.07.010},
journal = {The Brazilian Journal of Infectious Diseases},
pages = {412--421},
title = {Increase in COVID-19 inpatient survival following detection of Thromboembolic and Cytokine storm risk from the point of admission to hospital by a near real time Traffic-light System (TraCe-Tic)},
url = {http://dx.doi.org/10.1016/j.bjid.2020.07.010},
volume = {24},
year = {2020}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - IntroductionOur goal was to evaluate if traffic-light driven personalized care for COVID-19 was associated with improved survival in acute hospital settings.MethodsDischarge outcomes were evaluated before and after prospective implementation of a real-time dashboard with feedback to ward-based clinicians. Thromboembolic categories were “medium-risk” (D-dimer >1000 ng/mL or CRP >200 mg/L); “high-risk” (D-dimer >3000 ng/mL or CRP >250 mg/L) or “suspected” (D-dimer >5000 ng/mL). Cytokine storm risk was categorized by ferritin.Results939/1039 COVID-19 positive patients (median age 69 years, 563/939 (60%) male) completed hospital encounters to death or discharge by 21st May 2020. Thromboembolic flag criteria were reached by 568/939 (60.4%), including 238/275 (86.6%) of the patients who died, and 330/664 (49.7%) of the patients who survived to discharge, p < 0.0001. Cytokine storm flag criteria were reached by 212 (22.5%) of admissions, including 80/275 (29.0%) of the patients who died, and 132/664 (19.9%) of the patients who survived, p < 0.0001. The maximum thromboembolic flag discriminated completed encounter mortality (no flag: 37/371 [9.97%] died; medium-risk: 68/239 [28.5%]; high-risk: 105/205 [51.2%]; and suspected thromboembolism: 65/124 [52.4%], p < 0.0001). Flag criteria were reached by 535 consecutive COVID-19 positive patients whose hospital encounter completed before traffic-light introduction: 173/535 (32.3% [95% confidence intervals 28.0, 36.0]) died. For the 200 consecutive admissions after implementation of real-time traffic light flags, 46/200 (23.0% [95% confidence intervals 17.1–28.9]) died, p = 0.013. Adjusted for age and sex, the probability of death was 0.33 (95% confidence intervals 0.30–0.37) before traffic light implementation, 0.22 (0.17–0.27) after implementation, p < 0.001. In subgroup analyses, older patients, males, and patients with hypertension (p ≤ 0.01)
AU  - Vizcaychipi,MP
AU  - Shovlin,CL
AU  - McCarthy,A
AU  - Godfrey,A
AU  - Patel,S
AU  - Shah,PL
AU  - Hayes,M
AU  - Keays,RT
AU  - Beveridge,I
DO  - 10.1016/j.bjid.2020.07.010
EP  - 421
PY  - 2020///
SN  - 1413-8670
SP  - 412
TI  - Increase in COVID-19 inpatient survival following detection of Thromboembolic and Cytokine storm risk from the point of admission to hospital by a near real time Traffic-light System (TraCe-Tic)
T2  - The Brazilian Journal of Infectious Diseases
UR  - http://dx.doi.org/10.1016/j.bjid.2020.07.010
UR  - https://www.sciencedirect.com/science/article/pii/S1413867020301094?via%3Dihub
UR  - http://hdl.handle.net/10044/1/81951
VL  - 24
ER  -
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