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dc.creatorSun, Justin
dc.creatorYu, Daohai
dc.creatorYoo, Kevin
dc.creatorChoi, Robert
dc.creatorLu, Xiaoning
dc.creatorStandiford, Taylor
dc.creatorCohen, Gary
dc.creatorMarchetti, Nathaniel
dc.creatorAgosto, Omar
dc.creatorKumaran, Maruti
dc.creatorMaresky, Hillel
dc.identifier.citationSun, Justin MDa; Yu, Daohai PhDa; Yoo, Kevin MDa; Choi, Robert MDa; Lu, Xiaoning MSa; Standiford, Taylor MDa; Cohen, Gary MDb; Marchetti, Nathaniel DOc; Agosto, Omar MDb; Kumaran, Maruti MD, MBBS, FRCRb; Maresky, Hillel MDa,b,∗ Sextus chest radiograph severity score correlates to clinical outcomes in patients with COVID-19, Medicine: November 12, 2021 - Volume 100 - Issue 45 - p e27663
dc.description.abstractThe value of chest radiography (CXR) in detection and as an outcome predictor in the management of patients with coronavirus disease-2019 (COVID-19) has not yet been fully understood. To validate a standardized CXR scoring system and assess its prognostic value in hospitalized patients found to have COVID-19 by imaging criteria and to compare it to computed tomography (CT). In this cross-sectional chart review study, patients aged 18-years or older who underwent chest CT at a single institution with an imaging-based diagnosis of COVID-19 between March 15, 2020 to April 15, 2020 were included. Each patient's CXR and coronal CT were analyzed for opacities in a 6-zonal assessment method and aggregated into a “Sextus score.” Inter-reader variability and correlation between CXR and coronal CT images were investigated to validate this scoring system. Univariable and multiple logistic regression techniques were used to investigate relationships between CXR scores and clinical parameters in relation to patient outcomes. One hundred twenty-four patients (median [interquartile range] age 58.5 [47.5–69.0] years, 72 [58%] men, 58 [47%] Blacks, and 35 [28%] Hispanics) were included. The CXR Sextus score (range: 0–6) was reliable (inter-rater kappa = 0.76; 95% confidence interval [CI]: 0.69–0.83) and correlated strongly with the CT Sextus score (Spearman correlation coefficient = 0.75, P < .0001). Incremental increases of CXR Sextus scores of 2 points were found to be an independent predictor of intubation (adjusted odds ratio [95% CI]: 4.49 [1.98, 10.20], P = .0003) and prolonged hospitalization (≥10 days) (adjusted odds ratio [95% CI]: 4.06 [1.98, 8.32], P = .0001). The CXR Sextus score was found to be reproducible and CXR-CT severity scores were closely correlated. Increasing Sextus scores were associated with increased risks for intubation and prolonged hospitalization for patients with COVID-19 in a predominantly Black population. The CXR Sextus score may provide insight into identifying and monitoring high-risk patients with COVID-19.
dc.format.extent10 pages
dc.relation.ispartofCOVID-19 Research
dc.relation.isreferencedbyWolters Kluwe
dc.rightsAttribution CC BY
dc.subjectCoronavirus disease-2019 imaging
dc.subjectCXR-CT correlation
dc.subjectSerial chest radiography
dc.subjectSextus score
dc.titleSextus chest radiograph severity score correlates to clinical outcomes in patients with COVID-19: A cross-sectional study
dc.type.genreJournal article
dc.ada.noteFor Americans with Disabilities Act (ADA) accommodation, including help with reading this content, please contact
dc.description.schoolcollegeLewis Katz School of Medicine
dc.temple.creatorSun, Justin
dc.temple.creatorYu, Daohai
dc.temple.creatorYoo, Kevin
dc.temple.creatorChoi, Robert
dc.temple.creatorLu, Xiaoning
dc.temple.creatorStandiford, Taylor

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