Changes in the intrinsic severity of severe acute respiratory syndrome coronavirus 2 according to the emerging variant: a nationwide study from February 2020 to June 2022, including comparison with vaccinated populations.

BACKGROUND: As the population acquires immunity through vaccination and natural infection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), understanding the intrinsic severity of coronavirus disease (COVID-19) is becoming challenging. We aimed to evaluate the intrinsic severity regarding circulating variants of SARS-CoV-2 and to compare this between vaccinated and unvaccinated individuals. METHODS: With unvaccinated and initially infected confirmed cases of COVID-19, we estimated the case severity rate (CSR); case fatality rate (CFR); and mortality rate (MR), including severe/critical cases and deaths, stratified by age and compared by vaccination status according to the period regarding the variants of COVID-19 and vaccination. The overall rate was directly standardized with age. RESULTS: The age-standardized CSRs (aCSRs) of the unvaccinated group were 2.12%, 5.51%, and 0.94% in the pre-delta, delta, and omicron period, respectively, and the age-standardized CFRs (aCFRs) were 0.60%, 2.49%, and 0.63% in each period, respectively. The complete vaccination group had lower severity than the unvaccinated group over the entire period showing under 1% for the aCSR and 0.5% for the aCFR. The age-standardized MR of the unvaccinated group was 448 per million people per month people in the omicron period, which was 11 times higher than that of the vaccinated group. In terms of age groups, the CSR and CFR sharply increased with age from the 60 s and showed lower risk reduction in the 80 s when the period changed to the omicron period. CONCLUSIONS: The intrinsic severity of COVID-19 was the highest in the delta period, with over 5% for the aCSR, whereas the completely vaccinated group maintained below 1%. This implies that when the population is vaccinated, the impact of COVID-19 will be limited, even if a new mutation appears. Moreover, considering the decreasing intrinsic severity, the response to COVID-19 should prioritize older individuals at a higher risk of severe disease.

COVID-19 vs. Influenza: A Chest X-ray Comparison.

Introduction COVID-19 and influenza are primarily respiratory diseases, have similar symptoms with most patients developing mild to moderate illness, and show similar features on chest X-rays. We hypothesize that patients seeking treatments at the emergency department (ED) due to COVID-19 or influenza infection will have similar severity levels of features on chest X-rays, with most of them demonstrating normal to mildly abnormal chest X-ray findings.  Methods Chest X-ray images of 312 COVID-19 patients and 312 influenza patients were obtained from the teaching files of a general diagnostic radiologist. Images from each of these two groups were reviewed and classified. Based on the severity levels of lung abnormalities, each image was categorized into one of four categories: normal, mildly abnormal, moderately abnormal, or severely abnormal. The total number of images in each category within each disease group was counted, and the percentage was calculated compared to the total number of images analyzed in that group. Results from both groups were then compared. Results The severity levels of chest X-ray abnormalities were similar between the COVID-19 group and the COVID-negative influenza group at the time of ED visits, with most images being normal or mildly abnormal. The percentages of the images categorized as normal, mildly abnormal, moderately abnormal, and severely abnormal in the COVID-19 group and the influenza group were 38-39%, 28-29%, 22-21%, and 12-11%, respectively. Conclusion Our findings suggest that in the ED setting, no distinction can be made between COVID-19 and Influenza infections if based just on chest X-rays.

Antiviral drugs arbidol and interferon alpha-1b contribute to reducing the severity of COVID-19 patients: a retrospective cohort study.

OBJECTIVES: The aim of this study was to evaluate the role of antiviral drugs in reducing the risk of developing severe illness in patients with moderate COVID-19 pneumonia. METHODS: This retrospective cohort study included 403 adult patients with moderate COVID-19 pneumonia who were admitted to Shenzhen Third People's Hospital, China. The antiviral drugs arbidol, interferon alpha-1b, lopinavir-ritonavir and ribavirin were distributed to the patients for treatment. The primary endpoint of this study was the time to develop severe illness. RESULTS: Of the 462 patients admitted, 403 had moderate COVID-19 symptoms at hospital admission and were included in this study. 90 of the 403 (22.3%) patients progressed to severe illness. The use of arbidol was associated with a lower severity rate 3.5% compared to control group 30.5%, p-value < 0.0001; the adjusted hazard ratio was 0.28 (95% CI: 0.084-0.90, p = 0.033). The use of interferon alpha-1b was associated with a lower severity rate 15.5% compared to control group 29.3%, with p-value < 0.0001; the adjusted hazard ratio was 0.30 (95% CI: 0.15-0.58, p =  0.0005). The use of lopinavir-itonavir and ribavirin did not show significant differences in adjusted regression models. Early use of arbidol within 7 days of symptom onset was significantly associated with a reduced recovery time of - 5.2 days (IQR - 3.0 to - 7.5, p = 4e-06) compared with the control group. CONCLUSION: Treatment with arbidol and interferon alpha-1b contributes to reducing the severity of illness in patients with moderate COVID-19 pneumonia. Early use of arbidol may reduce patients' recovery time.

Regional-level risk factors for severe hand-foot-and-mouth disease: an ecological study from mainland China.

BACKGROUND: Severe hand-foot-and-mouth disease (HFMD) is a life-threatening contagious disease among young children and infants. Although enterovirus A71 has been well acknowledged to be the dominant cause of severe HFMD, there still remain other unidentified risk factors for severe HFMD. Previous studies mainly focused on identifying the individual-level risk factors from a clinical perspective, while rare studies aimed to clarify the association between regional-level risk factors and severe HFMD, which may be more important from a public health perspective. METHODS: We retrieved the clinical HFMD counts between 2008 and 2014 from the Chinese Center for Disease Control and Prevention, which were used to calculated the case-severity rate in 143 prefectural-level cities in mainland China. For each of those 143 cities, we further obtained city-specific characteristics from the China City Statistical Yearbook (social and economic variables) and the national meteorological monitoring system (meteorological variables). A Poisson regression model was then used to estimate the associations between city-specific characteristics (reduced by the principal component analysis to avoid multicollinearity) and the case-severity rate of HFMD. The above analysis was further stratified by age and gender to examine potential modifying effects and vulnerable sub-populations. RESULTS: We found that the case-severity rate of HFMD varied dramatically between cities, ranging from 0 to 8.09%. Cities with high case-severity rates were mainly clustered in Central China. By relating the case-severity rate to city-specific characteristics, we found that both the principal component characterized by a high level of social and economic development (RR = 0.823, 95%CI 0.739, 0.916) and another that characterized by warm and humid climate (RR = 0.771, 95%CI 0.619, 0.960) were negatively associated with the case-severity rate of HFMD. These estimations were consistent across age and gender sub-populations. CONCLUSION: Except for the type of infected pathogen, the case-severity rate of HFMD was closely related to city development and meteorological factor. These findings suggest that social and environmental factors may also play an important role in the progress of severe HFMD.

Regional-level risk factors for severe hand-foot-and-mouth disease: an ecological study from mainland China

BACKGROUND@#Severe hand-foot-and-mouth disease (HFMD) is a life-threatening contagious disease among young children and infants. Although enterovirus A71 has been well acknowledged to be the dominant cause of severe HFMD, there still remain other unidentified risk factors for severe HFMD. Previous studies mainly focused on identifying the individual-level risk factors from a clinical perspective, while rare studies aimed to clarify the association between regional-level risk factors and severe HFMD, which may be more important from a public health perspective.@*METHODS@#We retrieved the clinical HFMD counts between 2008 and 2014 from the Chinese Center for Disease Control and Prevention, which were used to calculated the case-severity rate in 143 prefectural-level cities in mainland China. For each of those 143 cities, we further obtained city-specific characteristics from the China City Statistical Yearbook (social and economic variables) and the national meteorological monitoring system (meteorological variables). A Poisson regression model was then used to estimate the associations between city-specific characteristics (reduced by the principal component analysis to avoid multicollinearity) and the case-severity rate of HFMD. The above analysis was further stratified by age and gender to examine potential modifying effects and vulnerable sub-populations.@*RESULTS@#We found that the case-severity rate of HFMD varied dramatically between cities, ranging from 0 to 8.09%. Cities with high case-severity rates were mainly clustered in Central China. By relating the case-severity rate to city-specific characteristics, we found that both the principal component characterized by a high level of social and economic development (RR = 0.823, 95%CI 0.739, 0.916) and another that characterized by warm and humid climate (RR = 0.771, 95%CI 0.619, 0.960) were negatively associated with the case-severity rate of HFMD. These estimations were consistent across age and gender sub-populations.@*CONCLUSION@#Except for the type of infected pathogen, the case-severity rate of HFMD was closely related to city development and meteorological factor. These findings suggest that social and environmental factors may also play an important role in the progress of severe HFMD.

[Preliminary analysis on COVID-19 case spectrum and spread intensity in different provinces in China except Hubei province].

Objective: To analyze the characteristics of COVID-19 case spectrum and spread intensity in different provinces in China except Hubei province. Methods: The daily incidence data and case information of COVID-19 were collected from the official websites of provincial and municipal health commissions. The morbidity rate, severity rate, case-fatality rate, and spread ratio of COVID-19 were calculated. Results: As of 20 March, 2020, a total of 12 941 cases of COVID-19 had been conformed, including 116 deaths, and the average morbidity rate, severity rate and case-fatality rate were 0.97/100 000, 13.5% and 0.90%, respectively. The morbidity rates in Zhejiang (2.12/100 000), Jiangxi (2.01/100 000) and Beijing (1.93/100 000) ranked top three. The characteristics of COVID-19 case spectrum varied from province to province. The first three provinces (autonomous region, municipality) with high severity rates were Tianjin (45.6%), Xinjiang (35.5%) and Heilongjiang (29.5%). The case-fatality rate was highest in Xinjiang (3.95%), followed by Hainan (3.57%) and Heilongjiang (2.70%). The average spread ratio was 0.98 and the spread intensity varied from province to province. Tibet had the lowest spread ratio (0), followed by Qinghai (0.20) and Guangdong (0.23). Conclusion: The intervention measures were effective in preventing the spread of COVID-19 and improved treatment effect in China. However, there were significant differences among different regions in severity, case-fatality rate and spread ratio.

Human Leukocyte Antigen (HLA) Class I Susceptible Alleles Against COVID-19 Increase Both Infection and Severity Rate.

Introduction Each country's difference in the severity rate of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may be explained by the difference in human leukocyte antigen (HLA) class I molecules, which affects the reactivity of cytotoxic T lymphocyte (CTL). Methods To clarify the relationship between HLA class I and the severity rate, the binding repertoires of each HLA class I allele to SARS-CoV-2 peptides and the allele frequencies of HLA-A, -B, and -A/B haplotypes in each country were quoted. Results HLA-A1 and the number of deaths per million population (severity rate) in each country had an exponential approximation correlation with correlation coefficient R=0.4879. In addition, the correlation between the infected cases per million (infection rate) and the severity rate was linearly approximated, with R=0.7422. Weak HLA-A alleles with a repertoire of under 300 also had an exponential approximation correlation with the severity rate (R=0.5972), whereas there was a linear approximation with the infection rate (R=0.6808). Weak HLA-B alleles of 30 repertoires or less had no correlation with the severity rate (R=-0.1530). The weak HLA-A/B haplotype has a stronger effect on the severity rate than the weak HLA-A alone. Therefore, the simple HLA class I susceptibility index was calculated, and a strong correlation (R=0.7388) of an exponential approximation with the severity rate was obtained. Conclusions HLA class I susceptible alleles against COVID-19 increase both infection and severity rate. The weak HLA-A is a major factor of severity rate, whereas the weak -B alone has no correlation. However, the weak HLA-A/B haplotype has a stronger effect on the severity rate than the weak -A alone.

Modeling of Individual and Organizational Factors Affecting Traumatic Occupational Injuries Based on the Structural Equation Modeling: A Case Study in Large Construction Industries.

BACKGROUND: Individual and organizational factors are the factors influencing traumatic occupational injuries. OBJECTIVES: The aim of the present study was the short path analysis of the severity of occupational injuries based on individual and organizational factors. MATERIALS AND METHODS: The present cross-sectional analytical study was implemented on traumatic occupational injuries within a ten-year timeframe in 13 large Iranian construction industries. Modeling and data analysis were done using the structural equation modeling (SEM) approach and the IBM SPSS AMOS statistical software version 22.0, respectively. RESULTS: The mean age and working experience of the injured workers were 28.03 ± 5.33 and 4.53 ± 3.82 years, respectively. The portions of construction and installation activities of traumatic occupational injuries were 64.4% and 18.1%, respectively. The SEM findings showed that the individual, organizational and accident type factors significantly were considered as effective factors on occupational injuries' severity (P < 0.05). CONCLUSIONS: Path analysis of occupational injuries based on the SEM reveals that individual and organizational factors and their indicator variables are very influential on the severity of traumatic occupational injuries. So, these should be considered to reduce occupational accidents' severity in large construction industries.

Analysis and Modeling of Threatening Factors of Workforce's Health in Large-Scale Workplaces: Comparison of Four-Fitting Methods to select optimum technique.

INTRODUCTION: Workforce is one of the pillars of development in any country. Therefore, the workforce's health is very important, and analyzing its threatening factors is one of the fundamental steps for health planning. This study was the first part of a comprehensive study aimed at comparing the fitting methods to analyze and model the factors threatening health in occupational injuries. METHODS: In this study, 980 human occupational injuries in 10 Iranian large-scale workplaces within 10 years (2005-2014) were analyzed and modeled based on the four fitting methods: linear regression, regression analysis, generalized linear model, and artificial neural networks (ANN) using IBM SPSS Modeler 14.2. RESULTS: Accident Severity Rate (ASR) of occupational injuries was 557.47 ± 397.87. The results showed that the mean of age and work experience of injured workers were 27.82 ± 5.23 and 4.39 ± 3.65 years, respectively. Analysis of health-threatening factors showed that some factors, including age, quality of provided H&S training, number of workers, hazard identification (HAZID), and periodic risk assessment, and periodic H&S training were important factors that affected ASR. In addition, the results of comparison of the four fitting methods showed that the correlation coefficient of ANN (R = 0.968) and the relative error (R.E) of ANN (R.E = 0.063) were the highest and lowest, respectively, among other fitting methods. CONCLUSION: The findings of the present study indicated that, despite the suitability and effectiveness of all fitting methods in analyzing severity of occupational injuries, ANN is the best fitting method for modeling of the threatening factors of a workforce's health. Furthermore, all fitting methods, especially ANN, should be considered more in analyzing and modeling of occupational injuries and health-threatening factors as well as planning to provide and improve the workforce's health.

Occupational safety indicators for forest operations, sawmilling and wood-based panels manufacture: an international benchmarking / Indicadores de seguridad ocupacional para operaciones forestales, aserraderos y fabricación de tableros en base a madera: una evaluación comparativa internacional

BACKGROUND: Given the lack of updated comparison to establish safety levels at where Chilean forestry and wood companies are facing with foreign competitors, a study of international statistical benchmarking was performed to find the rankings on occupational accidents and international excellence levels to achieve. METHOD: A survey was sent to 79 institutions and 96 contacts specialized in OHS from 37 countries to request data from years 2010 to 2012. The sample represented the workforce exposed to labor accidents that produces around 50% of roundwood and sawnwood, but 30% of wood-based panel globally. RESULTS: The study reinforces that the most accurate, reliable and easy indicator to calculate, and also, to compare the accidentability, is fatal cases per million cubic meter harvested in the forest or processed in wood industries. Zero fatality was recorded only in some activities on forest operations (Belgium and Germany) and wood-based panels manufacture (Belgium, Finland, Italy, Lithuania and Sweden). Also, all countries improved their previous results on fatalities per 1 million m3 in the forest. CONCLUSIONS: Chile exhibits an intermediate international position for Fatality rate and Production v/s fatalities in forestry & logging, sawmilling and wood-based panels operations. There are no clear trends to build reliable rankings for Frequency rate, Severity rate, Production v/s nonfatal accidents and Production v/s lost time in wood processing. Also, to make obvious the impact of labor accidents in forest and wood products, the study provides updated data and proposes to establish comparative indicators for the occupational accidents footprint between companies and/or countries.

ANTECEDENTES: Ante la falta de datos actualizados para establecer niveles referenciales de seguridad laboral a los cuales las empresas forestales y madereras chilenas se enfrentan versus sus competidores extranjeros, se realizó un estudio estadístico internacional comparativo para definir rankings y establecer niveles de excelencia a lograr en accidentalidad ocupacional. MÉTODO: Se distribuyó una encuesta a 79 instituciones y 96 contactos especializados en SST de 37 países, solicitando datos del 2010 al 2012. La muestra representó a trabajadores expuestos a accidentes laborales que producen alrededor del 50% de la madera rolliza y aserrada y el 30% de paneles en base a madera del mundo. RESULTADOS: El estudio reconfirma que el indicador más preciso, fiable y fácil de calcular, y también para comparar la accidentabilidad, es cantidad de casos fatales por millón m3 cosechados en el bosque o procesado en industrias madereras. Cero mortalidad se registró sólo en algunas operaciones forestales (Bélgica y Alemania) y fabricación de paneles de madera (Bélgica, Finlandia, Italia, Lituania y Suecia). Además, todos los países mejoraron sus resultados de trabajadores fallecidos por millón m3 en el bosque respecto a estudios previos. CONCLUSIONES: Chile exhibe una posición internacional intermedia para tasas de Fatalidad y Producción v/s Casos Fatales en cosecha forestal, aserraderos y fabricación de paneles a base de madera. No hay tendencias claras para elaborar rankings fiables con tasas de Frecuencia, Gravedad, Producción v/s Accidentes no fatales y Producción v/s Tiempo perdido en procesamiento de la madera. Para evidenciar el impacto de los accidentes de trabajo en productos del bosque y elaborados de la madera, el estudio presenta datos actualizados y propone establecer indicadores comparativos para la huella de accidentalidad laboral entre empresas y/o países.

Índice de severidad y afectación en la tiña pedis / Severity index involvement in tinea pedis

Introducción: la tiña pedis es una infección por dermatofitos que afecta a los pies e invade frecuentemente los espacios interdigitales, bordes laterales y plantas, la cual tiene una alta incidencia, tendencia a las recidivas y rebeldía a los tratamientos. Objetivo: evaluar la severidad de la tiña pedis escamosa a través del índice de severidad y afectación de la tiña pedis (ISATP). Métodos: estudio de evaluación en 347 pacientes a los que se les diagnosticó tiña pedis escamosa, que se atendieron por la especialidad de Dermatología del Hospital Militar Central Dr. Carlos J Finlay, entre septiembre de 2010 y septiembre de 2012. Se aplicó el algoritmo ISATP, desarrollado a partir del índice de severidad y área de psoriasis (PASI). Resultados: predominó el ISATP moderado con 46,6 por ciento. La mayor frecuencia se encontró en el grupo de 46 a 55 años (55,9 por ciento) y en el sexo masculino (73,1 por ciento). Según el color de la piel, los pacientes de piel blanca (40,0 por ciento) tuvieron el primer lugar. El ISATP severo prevaleció en el grupo etario de 56 a 65 años (50,0 por ciento), en el sexo masculino (93,5 por ciento) y en los pacientes de color de la piel negra (65,7 por ciento). Conclusiones: se comprobó que el algoritmo empleado, ISATP, es útil para definir los grados de severidad de las tiñas pedis escamosas de los pacientes en leves, moderados y severos; además permite relacionarlos con variables definidas de edad, sexo y color de la piel(AU)

Introduction: tinea pedis is a dermatophyte infection that affects feet and areas between toes, it often invades edges, sides and plants, it has a high incidence, tendency to relapse and rebellious to treatment. Objective: assess the severity of flaky tinea pedis through the rate of severity and impairment of tinea pedis (ISATP). Methods: an assessment study was conducted in 347 patients who were diagnosed with flaky tinea pedis. They were assisted in Dermatology services at Military Central Hospital, from September 2010 to September 2012. The ISATP algorithm was applied. It was developed from psoriasis area and severity rate (PASI). Results: moderate ISATP prevailed (46.6 percent). It was most frequently found in the age group of 46-55 years (55.9 percent), and in males (73.1 percent). Depending on the color of skin, white patients (40.0 percent) had the highest frequency. Severe ISATP prevailed in the age group of 56-65 years (50.0 percent) in males (93.5 percent) and in patients with black skin color (65.7 percent). Conclusions: the algorithm used, ISATP, is useful to define the degree of severity of squamous tinea pedis in patients as mild, moderate and severe; also, it allows defining variables relate to age, sex and skin color(AU)

Índice de severidad y afectación en la tiña pedis / Severity index involvement in tinea pedis

INTRODUCCIÓN: la tiña pedis es una infección por dermatofitos que afecta a los pies e invade frecuentemente los espacios interdigitales, bordes laterales y plantas, la cual tiene una alta incidencia, tendencia a las recidivas y rebeldía a los tratamientos. OBJETIVO: evaluar la severidad de la tiña pedis escamosa a través del índice de severidad y afectación de la tiña pedis (ISATP), MÉTODOS: estudio de evaluación en 347 pacientes a los que se les diagnosticó tiña pedis escamosa, que se atendieron por la especialidad de Dermatología del Hospital Militar Central "Dr. Carlos J Finlay", entre septiembre de 2010 y septiembre de 2012. Se aplicó el algoritmo ISATP, desarrollado a partir del índice de severidad y área de psoriasis (PASI). RESULTADOS: predominó el ISATP moderado con 46,6 %. La mayor frecuencia se encontró en el grupo de 46 a 55 años (55,9 %) y en el sexo masculino (73,1 %). Según el color de la piel, los pacientes de piel blanca (40,0 %) tuvieron el primer lugar. El ISATP severo prevaleció en el grupo etario de 56 a 65 años (50,0 %), en el sexo masculino (93,5 %) y en los pacientes de color de la piel negra (65,7 %). CONCLUSIONES: se comprobó que el algoritmo empleado, ISATP, es útil para definir los grados de severidad de las tiñas pedis escamosas de los pacientes en leves, moderados y severos; además permite relacionarlos con variables definidas de edad, sexo y color de la piel.

INTRODUCTION: tinea pedis is a dermatophyte infection that affects feet and areas between toes, it often invades edges, sides and plants, it has a high incidence, tendency to relapse and rebellious to treatment. OBJECTIVE: assess the severity of flaky tinea pedis through the rate of severity and impairment of tinea pedis (ISATP). METHODS: an assessment study was conducted in 347 patients who were diagnosed with flaky tinea pedis. They were assisted in Dermatology services at Military Central Hospital, from September 2010 to September 2012. The ISATP algorithm was applied. It was developed from psoriasis area and severity rate (PASI). RESULTS: moderate ISATP prevailed (46.6 %). It was most frequently found in the age group of 46-55 years (55.9 %), and in males (73.1 %). Depending on the color of skin, white patients (40.0 %) had the highest frequency. Severe ISATP prevailed in the age group of 56-65 years (50.0 %) in males (93.5 %) and in patients with black skin color (65.7 %). CONCLUSIONS: the algorithm used, ISATP, is useful to define the degree of severity of squamous tinea pedis in patients as mild, moderate and severe; also, it allows defining variables relate to age, sex and skin color.

Use of Artificial Neural Networks (ANNs) for the Analysis and Modeling of Factors That Affect Occupational Injuries in Large Construction Industries.

INTRODUCTION: Occupational injuries as a workforce's health problem are very important in large-scale workplaces. Analysis and modeling the health-threatening factors are good ways to promote the workforce's health and a fundamental step in developing health programs. The purpose of this study was ANN modeling of the severity of occupational injuries to determine the health-threatening factors and to introduce a model to predict the severity of occupational injuries. METHODS: This analytical chain study was conducted in 10 large construction industries during a 10-year period (2005-2014). Nine hundred sixty occupational injuries were analyzed and modeled based on feature weighting by the rough set theory and artificial neural networks (ANNs). Two analytical software programs, i.e., RSES and MATLAB 2014 were used in the study. RESULTS: The severity of occupational injuries was calculated as 557.47 ± 397.87 days. The findings of both models showed that the injuries' severity as a health problem resulted in various factors, including individual, organizational, health and safety (H&S) training, and risk management factors, which could be considered as causal and predictive factors of accident severity rate (ASR). CONCLUSION: The results indicated that ANNs were a reliable tool that can be used to analyze and model the severity of occupational injuries as one of the important health problems in large-scale workplaces. Additionally, the combination of rough set and ANNs is a good and proper chain approach to modeling the factors that threaten the health of workforces and other H&S problems.

A versão simplificada do Therapeutic Intervention Scoring System e seu valor prognóstico / The simplified version of Therapeutic Intervention Scoring System and its prognostic value / La versión simplificada del Therapeutic Intervention Scoring System y su valor pronóstico

O estudo avalia a capacidade do Therapeutic Intervention Scoring System (TISS-28) de discriminar pacientes internados em UTI, prováveis de morrer daqueles possíveis de sobreviver e estabelecer a pontuação limiar para alta probabilidade de morte. Os resultados, obtidos da amostra de 200 pacientes internados em 14 UTIs do Município de São Paulo, mostraram que o TISS-28 apresentou associação com mortalidade (p=0,0001). O ponto de corte estabelecido foi 21. Encontrou-se que 80,88 por cento dos que morreram tinham pontuação do TISS-28 maior ou igual, e 68,18 por cento dos sobreviventes tinham pontuação menor que 21. Além disso, quanto ao valor prognóstico do TISS-28, constatou-se acurácia de 0,72.

The study evaluates the competence of the "TISS-28" to distinguish inpatients at the ICU, between the ones likely to die from the ones likely to survive and to establish a threshold score for high likelihood to death. The findings obtained by the sample of 200 inpatients at 14 ICUs in Sao Paulo County showed that the TISS-28 presented association with mortality (p=0.0001). The cutting score established was 21. It was found that 80.88 percent of those who died had the TISS-28 score similar or higher and 68.18 percent of survivors had the score below 21. Furthermore, regarding to the prognostic value of TISS-28, it was showed up the accuracy of 0.72.

El estudio evalúa la capacidad del Therapeutic Intervention Scoring System (TISS-28) para discriminar pacientes internados en UCI, probables de morir de aquellos posibles de sobrevivir y establecer la puntuación límite para la alta probabilidad de muerte. Los resultados, obtenidos de la muestra de 200 pacientes internados en 14 UCIs del Municipio de São Paulo, mostraron que el TISS-28 presentó asociación con la mortalidad (p=0,0001). El punto de corte establecido fue 21. Se encontró que el 80.88 por ciento de los que murieron tenían puntuación del TISS-28 mayor o igual, y 68.18 por ciento de los sobrevivientes tenían puntuación menor que 21. Además de eso, en cuanto al valor pronóstico del TISS-28, se constató exactitud de 0.72.