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|Title:||A prediction rule to stratify mortality risk of patients with pulmonary tuberculosis|
|Author(s):||Bastos, Hélder Novais|
Osório, Nuno S.
Castro, António G.
Costa, Patrício Soares
Ferreira, Ivo Ricardo Silva
Magalhães, Sara Pinto
Rodrigues, Fernando José dos Santos
Castro, Rui Manuel Rosário Sarmento
Guimarães, João Tiago
|Publisher:||Public Library of Science|
|Citation:||Bastos, H. N., Osório, N. S., Castro, A. G., Ramos, A., et. al. (2016). A Prediction Rule to Stratify Mortality Risk of Patients with Pulmonary Tuberculosis. PloS one, 11(9), e0162797. doi: 10.1371/journal.pone.0162797|
|Abstract(s):||Tuberculosis imposes high human and economic tolls, including in Europe. This study was conducted to develop a severity assessment tool for stratifying mortality risk in pulmonary tuberculosis (PTB) patients. A derivation cohort of 681 PTB cases was retrospectively reviewed to generate a model based on multiple logistic regression analysis of prognostic variables with 6-month mortality as the outcome measure. A clinical scoring system was developed and tested against a validation cohort of 103 patients. Five risk features were selected for the prediction model: hypoxemic respiratory failure (OR 4.7, 95% CI 2.8-7.9), age >= 50 years (OR 2.9, 95% CI 1.7-4.8), bilateral lung involvement (OR 2.5, 95% CI 1.44.4), >= 1 significant comorbidity-HIV infection, diabetes mellitus, liver failure or cirrhosis, congestive heart failure and chronic respiratory disease-(OR 2.3, 95% CI 1.3-3.8), and hemoglobin < 12 g/dL (OR 1.8, 95% CI 1.1-3.1). A tuberculosis risk assessment tool (TReAT) was developed, stratifying patients with low (score <= 2), moderate (score 3-5) and high (score >= 6) mortality risk. The mortality associated with each group was 2.9%, 22.9% and 53.9%, respectively. The model performed equally well in the validation cohort. We provide a new, easy-to-use clinical scoring system to identify PTB patients with high-mortality risk in settings with good healthcare access, helping clinicians to decide which patients are in need of closer medical care during treatment.|
|Appears in Collections:||ICVS - Artigos em Revistas Internacionais com Referee|