ABSTRACT
To evaluate the predictive value of early warning scores for intensive care unit (ICU) admission in patients with coronavirus disease 2019 (COVID-19). For COVID-19 patients who were admitted to Shijiazhuang People's Hospital from January 2021 to February 2021, national early warning score (NEWS), national early warning score 2 (NEWS2), rapid emergency medicine score (REMS), quick sepsis-related organ failure (qSOFA), altered consciousness, blood urea nitrogen, respiratory rate, blood pressure, and age-65 (CURB-65) were used to evaluate the inpatient condition and the predictive value for ICU admission. A total of 368 patients were included, and 32 patients (8.7%) were transferred to the ICU. The median age was 49.0 (34.0,61.0) years. The scores of NEWS, NEWS2, REMS, and CURB-65 were 1 (0, 2), 1 (0, 2), 4 (2, 6) and 0 (0, 1), respectively. The receiver operating characteristic (ROC) cure (AUC) was used to evaluate the predictive value in detecting patients who are at risk of being transferred to the ICU. Area under the ROC AUC of NEWS was 0.756, sensitivity 65.6%, and specificity 71.3%. ROC AUC of NEWS2 was 0.732, sensitivity 62.5%, and specificity 61.3%. ROC AUC of REMS was 0.787, sensitivity 84.4%, and specificity 64.6%. ROC AUC of CURB-65 was 0.814, sensitivity 81.3%, and specificity 76.8%. The predictive value of NEWS and NEWS2 combined with age were significantly improved. The ROC AUC of NEWS combined with age was 0.885, sensitivity 85.1%, and specificity 75.0%. The ROC AUC of NEWS2 combined with age was 0.883, sensitivity 84.2%, and specificity 75.0%. NEWS and NEWS2 combined with age can be used as a predictive tool for whether COVID-19 patients will be admitted to the ICU.
Subject(s)
COVID-19 , Humans , Middle Aged , Aged , Retrospective Studies , Hospitalization , Intensive Care Units , ROC Curve , Prognosis , Hospital MortalityABSTRACT
PurposeDrawing on a strategic agility perspective, the authors develop a theoretical framework and empirically examine how digital platform adoption and capability impact business performance via digital-enabled strategic agility in the context of professional service firms.Design/methodology/approachThe authors propose and examine a conceptual framework based on survey data from 127 professional service firms in New Zealand.FindingsThis study reveals the impact of digital platform capability on the business performance of professional service firms that employ digital platform technologies. The results suggest that organizational innovation and managers' creative efficacy will be used as distal antecedents and contribute to digital platform capabilities. In addition, digital strategic agility can mediate the link between digital platform capabilities and business performance.Originality/valueThis study is one of the first to investigate when and how digital platforms empower professional service firms. This study reveals the role of digital strategic agility and digital platform capabilities in knowledge-intensive enterprises. This research advances the development of knowledge-based economy in the information age by applying and extending strategic agility to the uncertain and volatile business environment. The authors' new conceptualization provides a deeper understanding of how and why professional services business and organizations can adapt to the post-COVID era smoothly and successfully.
ABSTRACT
Background. Few studies reported the risk factors of fatal outcome of hospitalized patients with coronavirus disease 2019 (COVID-19). We aimed to identify the independent risk factors associated with fatal outcome of hospitalized COVID-19 patients. Methods. The clinical data of 109 consecutive COVID-19 patients including 40 (36.7%) common cases and 69 (63.3%) severe cases were included and analyzed. Results: Multivariate regression analysis indicated that platelets (PLT, OR, 0.988;95% CI, 0.978-0.998;P=0.017) and C-reactive protein (CRP) (OR, 1.047;95% CI, 1.026-1.068;P<0.001) levels were the independent risk factors of fatal outcome in COVID-19 patients. The optimal cut-off value of PLT counts for predicting fatal outcome was 161x109/L with the area under receiver operating characteristic curve (AUROC) of 0.824 (95% CI, 0.739-0.890). The optimal cut-off value of CRP for the prediction of fatal outcome was 46.2 mg/L with the AUROC of 0.954 (95% CI, 0.896-0.985). The CRP levels had higher predictive values for fatal outcome than PLT (P=0.016). The cumulative survival rate was significantly higher in patients with PLT>161x10(9)/L compared with patients with PLT <= 161x10(9)/L (89.4% vs. 12.5%, log-rank test chi(2)=72.17;P<0.001). Survival rate of COVID-19 patients was prominently higher in CRP <= 46.2 mg/L patients compared with patients with CRP>46.2 mg/L (95.9% vs. 22.9%, log-rank test chi(2)=77.85;P<0.001). Conclusions. PLT counts and CRP levels could predict fatal outcome of hospitalized COVID-19 patients with relatively high accuracy.
ABSTRACT
According to the discussion of the design method and operational effect for Wuhan Huoshenshan Hospital, this paper summarized the design control points of indoor and outdoor environment of COVID-19 emergency hospital. Based on the design of Wuhan Huoshenshan Hospital, this paper analyzed and discussed the site design, building layout, three-zones and two-passages, the design scheme of the ventilation and air conditioning system for negative pressure ward and negative pressure isolation ward, air distribution, as well as some other key designs for COVID-19 emergency hospital. The design points were summarized and refined. The design methods and technology requirements of the COVID-19 emergency hospital were provided in this study, such as ventilation and air conditioning system setting, ventilation quantity of wards, pressure gradient control measures among different areas, upper and lower air distribution, filter setting mode and distance of air inlet and outlet, which could benefit to provide references for the design of similar projects in the future.