Correlation of Brixia Score Changes with Length of Stay in Patient with COVID-19
Abstract
Background: The increase in Covid-19 cases in Indonesia as well as the hospital length of stay is unpredictable. The degree of lung damage in Covid-19 largely determines the severity of the disease, a serial chest X-ray using Brixia score can be used to assess changes in pulmonary parenchymal damage and could predict the length of hospitalization. This study aims to analyze the correlation of Brixia score with the length of hospitalization in Covid-19 patients.
Subjects and Method: This cross-sectional study was conducted at Sumber Waras Hospital from November 2021 until January 2022. The samples are Covid-19 confirmed patients who were treated at Sumber Waras hospital. Independent variable is Brixia score and dependent variable is length of hospitalization. Brixia's score assessment from two serial chest X-rays was divided into 4 categories: low to low, low to high, high to low, and high to high. All the categories were analyzed using Kruskall-Wallis method then continued with Mann-Whitney U test. The multivariate variable was analyzed using linear regression.
Results: There are 190 samples, the median score of Brixia at the beginning of treatment is 4 (range 0-18), and the median score of Brixia on serial examination is 6 (range 0-18). Patients in low to low category had median 10 days length of hospitalization, low to high category and high to low category had median 11 days, and high to high category had median 8 days. There was no statistically significant correlation between Brixia score and length of hospitalization (p= 0.377).
Conclusion: There is no significant relationship between the median Brixia score changes with the length of hospitalization of covid-19 patients.
Keywords: Covid-19, hospitalized, Brixia score changes, length of stay
Correspondence: Widiastuti Soewondo. Faculty of Medicine Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta, Central Java, Indonesia. Mobile: +6282134368592. Email: widiastuti.sprad56@staff.uns.ac.id.
Indonesian Journal of Medicine (2022), 07(03): 262-268
https://doi.org/10.26911/theijmed.2022.07.03.02
References
AuYong I, Higashi Y, Giannotti E, Fogarty A, Morling JR, Grainge M, Race A, et al. (2022). Chest Radiograph Scoring Alone or Combined with Other Risk Scores for Predicting Outcomes in COVID19. Radiology. 302(2): 460–469. doi: 10.1148/radiol.2021210986.
Borghesi A, Maroldi R (2020). COVID19 outbreak in Italy: experimental chest Xray scoring system for quantifying and monitoring disease progression. Radiol Med. 125(5): 509–513. doi: 10.1007/s11547020012003.
hams N, Chams S, Badran R, Shams A, Araji A, Raad M, Mukhopadhyay S, Stroberg E, Duval EJ, Barton LM, Hajj Hussein I (2020). COVID19: A Multidisciplinary Review. Front Public Health. 8: 383. doi: 10.3389/fpubh.2020.00383.
Chiari M, Gerevini AE, Maroldi R, Olivato M, Putelli L, Serina I (2021). Length of Stay Prediction for Northern Italy COVID19 Patients Based on Lab Tests and XRay Data. ICPR International Workshops and Challenges. Cham: Springer International Publishing. 212–226. doi: 10.1007/9783030687632_16.
Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, Zhang L, et al. (2020). Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 395(10223): 497–506. doi: 10.1016/S0140 6736(20)301835.
Kemenkes RI. (2021). Angka kesembuhan Covid19. Kementerian Kesehatan Republik Indonesia. www.covid19.go.id.
Khosravi B, Aghaghazvini L, Sorouri M, Naybandi Atashi S, Abdollahi M, Mojtabavi H, Khodabakhshi M, et al. (2021). Predictive value of initial CT scan for various adverse outcomes in patients with COVID19 pneumonia. Heart Lung. 50(1): 1320. doi: 10.1016/j.hrtlng.2020.10.005a/.
Kim HW, Capaccione KM, Li G, Luk L, Widemon RS, Rahman O, Beylergil V, et al. (2020). The role of initial chest Xray in triaging patients with suspected COVID19 during the pandemic. Emerg Radiol. 27(6): 617 621. doi: 10.1007/S1014002001808y.
Liu Y, Gayle AA, WilderSmith A, Rocklöv J (2020). The reproductive number of COVID19 is higher compared to SARS coronavirus. J Travel Med. 27(2): taaa021. doi: 10.1093/jtm/taaa021.
Maroldi R, Rondi P, Agazzi GM, Ravanelli M, Borghesi A, Farina D (2021). Which role for chest xray score in predicting the outcome in COVID19 pneumonia? Eur Radiol. 31(6):40164022. doi: 10.1007/s00330020075042.
Sathi S, Tiwari R, Verma S, Kumar Garg A, Singh Saini V, Kumar Singh M, Mittal A, et al. (2021). Role of Chest XRay in Coronavirus Disease and Correlation of Radiological Features with Clinical Outcomes in Indian Patients. Can J Infect Dis Med Microbiol. 2021: 6326947. doi: 10.1155/2021/6326947.
Soewondo W, Kusumaningrum CS, Hanafi M, Adiputri A, Hayuningrat PK (2022). Coexisting active pulmonary tuberculosis with aspergilloma in a diabetic patient: A rare case report. Radiol Case Rep. 17(4):11361142. doi: 10.1016/j.radcr.2021.12.064.
Soewondo W, Putro PS, Hermansah ML, Lestari L, Reviono, Harsini, Adhiputri A (2021). Long Covid19, Radiological Findings, and Its Management: A Systematic Review. Indones J Med. 06(04): 387392. doi: 10.26911/theijmed.2021.06.04.04.
Toussie D, Voutsinas N, Finkelstein M, Cedillo MA, Manna S, Maron SZ, Jacobi A, et al. (2020). Clinical and Chest Radiography Features Determine Patient Outcomes in Young and Middleaged Adults with COVID19. Radiology. 297(1): E197E206. doi: 10.1148/radiol.2020201754.
Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, Wang B, et al. (2020). Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel CoronavirusInfected Pneumonia in Wuhan, China. JAMA. 323(11):10611069. doi: 10.1001/jama.2020.1585.
Worldometer (2021). Indonesia COVID: 4,234,758 Cases and 142,952 Deaths. Available at: https://www.worldometers.info/coronavirus/country/indonesia.