ABSTRACT
IntroductionWithin the UK, COVID-19 has contributed towards over 103,000 deaths. Multiple risk factors for COVID-19 have been identified including various demographics, co-morbidities, biochemical parameters, and physical assessment findings. However, using this vast data to improve clinical care has proven challenging. Aimsto develop a reliable, multivariable predictive model for COVID-19 in-patient outcomes, to aid risk-stratification and earlier clinical decision-making. MethodsAnonymized data regarding 44 independent predictor variables of 355 adults diagnosed with COVID-19, at a UK hospital, was manually extracted from electronic patient records for retrospective, case-controlled analysis. Primary outcomes included inpatient mortality, level of ventilatory support and oxygen therapy required, and duration of inpatient treatment. Secondary pulmonary embolism was the only secondary outcome. After balancing data, key variables were feature selected for each outcome using random forests. Predictive models were created using Bayesian Networks, and cross-validated. ResultsOur multivariable models were able to predict, using feature selected risk factors, the probability of inpatient mortality (F1 score 83.7%, PPV 82%, NPV 67.9%); level of ventilatory support required (F1 score varies from 55.8% "High-flow Oxygen level" to 71.5% "ITU-Admission level"); duration of inpatient treatment (varies from 46.7% for "[≥] 2 days but < 3 days" to 69.8% "[≤] 1 day"); and risk of pulmonary embolism sequelae (F1 score 85.8%, PPV of 83.7%, and NPV of 80.9%). ConclusionOverall, our findings demonstrate reliable, multivariable predictive models for 4 outcomes, that utilize readily available clinical information for COVID-19 adult inpatients. Further research is required to externally validate our models and demonstrate their utility as clinical decision-making tools. HighlightsO_LIUsing COVID-19 risk-factor data to assist clinical decision making is a challenge C_LIO_LIAnonymous data from 355 COVID-19 inpatients was collected & balanced C_LIO_LIKey independent variables were feature selected for 4 different outcomes C_LIO_LIAccurate, multi-variable predictive models were computed, using Bayesian Networks C_LIO_LIFuture research should externally validate our models & demonstrate clinical utility C_LI
ABSTRACT
Objective: To determine the knowledge, attitude and practice of healthcare workers in Kermanshah Province about Crimean-Congo hemorrhagic fever (CCHF). Methods: This study was conducted in 2014 on healthcare personnel in different job categories including physicians, nurses, midwives, laboratory staff and network health staff of Kermanshah Province by direct interview. Results: A total of 367 respondents who had more than 5 years of experience in their jobs were interviewed. Among them 91% of physicians and nurses, 97% of midwives and health workers and 96% of laboratory staff stated that they had not been confronted with CCHF patients so far. Regarding knowledge, 76% of physicians, 78% of nurses, 77% of midwives and 58% of laboratory staff believed that the disease is remediable. Most of the interviewed participants stated that the disease pertains to people who are in close contact with domestic animals, but they did not consider their own occupations as one of the risk factors. More than 70% of the respondents believed that the disease may exist in the province or their work field. Generally, the knowledge about CCHF was inadequate, with nurses having the lowest level of knowledge. Conclusions: Knowledge of Kermanshah healthcare staff about CCHF was poor, especially nurses in a high risk job category. Therefore, it is necessary to conduct specific training programs for the disease identification, transmission, prevention, and treatment as well as the use of personal protection and safety devices.