{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T02:49:58Z","timestamp":1772160598416,"version":"3.50.1"},"reference-count":29,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2021,4,1]],"date-time":"2021-04-01T00:00:00Z","timestamp":1617235200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Advanced Nursing"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To assess whether the application of a non\u2010invasive tool, such as ratio of oxygen saturation (ROX) index, during triage can identify patients with COVID\u201019 at high risk of developing acute respiratory distress syndrome (ARDS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A multi\u2010centre, observational, retrospective study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Only COVID\u201019 positive patients who required an emergency department evaluation for dyspnoea were considered. The primary objective of the study was to compare the ROX value obtained during triage with the medical diagnosis of ARDS and intubation in 72\u00a0h of the triage evaluation. The ROX index value was also compared with objective outcomes, such as the pressure of arterial O\n                      <jats:sub>2<\/jats:sub>\n                      (PaO\n                      <jats:sub>2<\/jats:sub>\n                      )\/fraction of inspired oxygen (FiO\n                      <jats:sub>2<\/jats:sub>\n                      ) ratio and the lung parenchyma volume involved in COVID\u201019\u2010related inflammatory processes, based on 3D reconstructions of chest computed tomography (CT).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      During the study period, from 20 March 2020 until 31 May 2020, a total of 273 patients with confirmed SARS\u2010CoV\u20102 infection were enrolled. The predictive ability of ROX for the risk of developing ARDS in 72\u00a0h after triage evaluation was associated with an area under the receiver operating characteristic (AUROC) of 0.845 (0.797\u20130.892,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001), whereas the AUROC value was 0.727 (0.634\u20130.821,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001) for the risk of intubation. ROX values were strongly correlated with PaO\n                      <jats:sub>2<\/jats:sub>\n                      \/FiO\n                      <jats:sub>2<\/jats:sub>\n                      values (\n                      <jats:italic>r<\/jats:italic>\n                      \u00a0=\u00a00.650,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001), decreased ROX values were associated with increased percentages of lung involvement based on 3D CT reconstruction (\n                      <jats:italic>r<\/jats:italic>\n                      \u00a0=\u00a0\u22120.371,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      The ROX index showed a good ability to identify triage patients at high evolutionary risk. Correlations with objective but more invasive indicators (PaO\n                      <jats:sub>2<\/jats:sub>\n                      \/FiO\n                      <jats:sub>2<\/jats:sub>\n                      and CT) confirmed the important role of ROX in identifying COVID\u201019 patients with extensive pathological processes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Impact<\/jats:title>\n                    <jats:p>During the difficult triage evaluation of COVID\u201019 patients, the ROX index can help the nurse to identify the real severity of the patient. The triage systems could integrate the ROX in the rapid patient assessment to stratify patients more accurately.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jan.14848","type":"journal-article","created":{"date-parts":[[2021,4,1]],"date-time":"2021-04-01T08:26:22Z","timestamp":1617265582000},"page":"3361-3369","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["The ROX index can be a useful tool for the triage evaluation of COVID\u201019 patients with dyspnoea"],"prefix":"10.1111","volume":"77","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4204-8884","authenticated-orcid":false,"given":"Arian","family":"Zaboli","sequence":"first","affiliation":[{"name":"Emergency Department Hospital of Merano (SABES\u2010ASDAA) Merano\u2010Meran Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dietmar","family":"Ausserhofer","sequence":"additional","affiliation":[{"name":"College of Health Care Professions Claudiana Bolzano\u2010Bozen Italy"},{"name":"Institute of Nursing Science Department of Public Health University of Basel Basel Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Norbert","family":"Pfeifer","sequence":"additional","affiliation":[{"name":"Emergency Department Hospital of Merano (SABES\u2010ASDAA) Merano\u2010Meran Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Serena","family":"Sibilio","sequence":"additional","affiliation":[{"name":"Emergency Department Hospital of Merano (SABES\u2010ASDAA) Merano\u2010Meran Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giovanna","family":"Tezza","sequence":"additional","affiliation":[{"name":"Department of Paediatrics Hospital of Merano (SABES\u2010ASDAA) Merano Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Ciccariello","sequence":"additional","affiliation":[{"name":"Emergency Department Hospital of Bressanone (SABES\u2010ASDAA) Bressanone\u2010Brixen Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gianni","family":"Turcato","sequence":"additional","affiliation":[{"name":"Emergency Department Hospital of Merano (SABES\u2010ASDAA) Merano\u2010Meran 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