4.1 Strength and limitation
There are certain limitations to this analysis. For one, as this study
was retrospective in design, it is susceptible to selection bias.
Nucleic acid tests, for example, we conducted based upon the subjective
judgment of the attending physicians such that only patients with more
severe disease may have undergone such testing, rather than all
potentially eligible patients. Furthermore, it was possible that a very
few patients required IMV were not intubated owing to noncompliance. As
this study was retrospective, we were also unable to retrieve and
evaluate patient vaccination data or other missing information,
potentially constraining the accuracy of our findings. Patients were
also not routinely evaluated for other respiratory viruses, and we are
thus unable to exclude the possibility that certain patients may have
been co-infected with multiple viruses.
ConclusionIn summary, we developed a reliable and straightforward predictive
tool capable of gauging the odds of a given hospitalized Flu-p patient
requiring IMV. This tool will help clinicians better evaluate the
risks of early intubation for any given patient such that they can
make optimal clinical judgments. However, it should be evaluated in
more large-sample and prospective studies.