Introduction: Computed Tomography (CT) plays a pivotal role in the diagnosis of Coronavirus Disease-2019 (COVID-19) pneumonia. Various scoring systems have also been proposed for prognostic purposes; but their validation in the Indian setting has not been widely done. Aim: To compare the CT Severity Score (CTSS) of lung involvement with the clinical severity of COVID-19 pneumonia. Materials and Methods: A single centre hospital-based cross- sectional observational study was conducted from October 2020 to April 2021 at Holy Family Hospital, New Delhi, India. Hundred hospitalised Reverse Transcription Polymerase Chain Reaction (RT-PCR) positive COVID-19 pneumonia adult patients underwent thoracic CT scans within 24 hours of hospitalisation for quantification of pulmonary involvement, which were reviewed to obtain the CTSS. The association between CTSS and the clinical profile of the patients (clinical severity of COVID-19 pneumonia at admission as per Ministry of Health and Family Welfare guidelines, duration of hospitalisation, clinical outcome, and number of co- morbidities) was determined. Fisher’s exact test was used for categorical variables and the two sample Student’s t-test for continuous variables. A p-value <0.05 was considered significant. results: Mean age of study participants was 57.8±14.8 years (range 24-90 years); and male to female ratio was 3:2. There was a statistically significant association between the CTSS and clinical severity of COVID-19 pneumonia (p<0.001). Significant association was observed between the CTSS and duration of hospital stay (p-value <0.001). Significant association was also observed between CTSS and clinical outcome of patients (p-value=0.002). Significant association was also observed between CTSS and number of co-morbidities (p-value=0.002). conclusion: The CTSS had a statistically significant association with the clinical severity of COVID-19 pneumonia, as well as with the duration of hospital stay and the clinical outcome.
Background: Early risk stratification of patients with upper gastrointestinal bleeding (UGIB) is of utmost importance for a favourable patient outcome. It ensures patient triaging into the appropriate level of care, avoiding unnecessary and prolonged hospitalisations on one end and rapid identification of high-risk patients for emergent management on the other.
Methods: This prospective observational study was carried out on 150 patients who met the inclusion criteria. Demographic data, baseline lab parameters, Rockall scores, endoscopic interventions, re-bleeding, duration of hospital stay and mortality were recorded. Based on the Rockall scores, patients were divided as low, moderate and high risk.
Results: Variceal bleeding was the most common cause of UGIB (34%). The need for therapeutic endoscopy, risk of re-bleeding and duration of hospital stay were proportional to the severity of the risk as per Rockall score (p-value < 0.01). Among the study subjects, one patient in high-risk category expired.
Conclusion: Rockall scoring system helps in the risk stratification of UGIB patients and hence early intervention in high-risk patients. Higher scores are associated with poor patient outcomes.
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