Chest Radiograph Scoring Alone or Combined with Other Risk Scores for Predicting Outcomes in COVID-19

Background Radiographic severity may help predict patient deterioration and outcomes from COVID-19 pneumonia. Purpose To assess the reliability and reproducibility of three chest radiograph reporting systems (radiographic assessment of lung edema [RALE], Brixia, and percentage opacification) in patients with proven SARS-CoV-2 infection and examine the ability of these scores to predict adverse outcomes both alone and in conjunction with two clinical scoring systems, National Early Warning Score 2 (NEWS2) and International Severe Acute Respiratory and Emerging Infection Consortium: Coronavirus Clinical Characterization Consortium (ISARIC-4C) mortality. Materials and Methods This retrospective cohort study used routinely collected clinical data of patients with polymerase chain reaction-positive SARS-CoV-2 infection admitted to a single center from February 2020 through July 2020. Initial chest radiographs were scored for RALE, Brixia, and percentage opacification by one of three radiologists. Intra- and interreader agreement were assessed with intraclass correlation coefficients. The rate of admission to the intensive care unit (ICU) or death up to 60 days after scored chest radiograph was estimated. NEWS2 and ISARIC-4C mortality at hospital admission were calculated. Daily risk for admission to ICU or death was modeled with Cox proportional hazards models that incorporated the chest radiograph scores adjusted for NEWS2 or ISARIC-4C mortality. Results Admission chest radiographs of 50 patients (mean age, 74 years ± 16 [standard deviation]; 28 men) were scored by all three radiologists, with good interreader reliability for all scores, as follows: intraclass correlation coefficients were 0.87 for RALE (95% CI: 0.80, 0.92), 0.86 for Brixia (95% CI: 0.76, 0.92), and 0.72 for percentage opacification (95% CI: 0.48, 0.85). Of 751 patients with a chest radiograph, those with greater than 75% opacification had a median time to ICU admission or death of just 1-2 days. Among 628 patients for whom data were available (median age, 76 years [interquartile range, 61-84 years]; 344 men), opacification of 51%-75% increased risk for ICU admission or death by twofold (hazard ratio, 2.2; 95% CI: 1.6, 2.8), and opacification greater than 75% increased ICU risk by fourfold (hazard ratio, 4.0; 95% CI: 3.4, 4.7) compared with opacification of 0%-25%, when adjusted for NEWS2 score. Conclusion Brixia, radiographic assessment of lung edema, and percentage opacification scores all reliably helped predict adverse outcomes in SARS-CoV-2 infection. © RSNA, 2021 Online supplemental material is available for this article. See also the editorial by Little in this issue

Conférence plénière du XLVe Congrès de la SAES

I was asked to talk to this conference, I think, because the organisers considered I might be one of the few popular novelists who could contemplate something entitled Texte(s) contexte(s) hors-texte(s) without going weak at the knees. It may be they anticipated a talk about the writer’s art, and possibly wanted some account of the differences between writing as an academic and writing as a novelist, but I fear they are going to be somewhat disappointed: I am singularly unreflective about wha..

Espaces et terres d’Amérique

Les textes qui composent ce recueil prolongent le colloque "Espaces et Terres d'Amérique" organisé les 7-8 avril 2005 à Toulouse par le Groupe d'Etudes Nord-Américaines (G.E.N.A.), composante du centre Cultures Anglo-Saxonnes (C.A.S.). La thématique de ce recueil a attiré des chercheurs spécialisés tout aussi bien en littérature qu'en civilisation, en histoire ou en linguistique. Il est vrai que l'espace nord-américain se prête à des analyses transdisciplinaires. Les articles, qui traitent de questions de société, d'histoire, de littérature et de culture plus généralement, s'intéressent aux diverses définitions de l'espace américain mais aussi au rapport qu'entretiennent les Américains avec les notions d'espace et de territoire. L'ouvrage examine également des phénomènes identitaires d'autant plus intéressants que cette nation, dont on dit qu'elle est "terre d'immigration," est un laboratoire favorable à l'étude de tels phénomènes. Enfin, il étudie la cartographie de l'espace dressée par les artistes aux États-Unis et la façon dont cet espace est représenté dans la littérature et le cinéma américains The, articles collected in this volume grew out of the conference on "Mapping American Space/ Espaces et Terres d'Amérique," hosted by the North American research group (G.E.N.A.), a member of the Anglophone Culture Center (C.A.S.), at the University of Toulouse on April 7-8, 2005. This volume brings together researchers specializing in literature, history, cultural studies and linguistics, for American space is open to all kinds of enquiries. The articles deal with social, historical, literary, and, more generally, cultural topics, examining not only the different ways of defining American space but also the conceptions Americans entertain in relation to space and territoriality. The questions of identity examined here are all the more absorbing as this nation founded on immigration constitutes a real laboratory for the study of these issues. Finally, this volume looks at the ways in which American artists have mapped American space imaginatively and figured its organization through cinematic and literary representations