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.