A prediction rule to stratify mortality risk of patients with pulmonary tuberculosis
Autor(a) principal: | |
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Data de Publicação: | 2016 |
Outros Autores: | , , , , , , , , , , , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://hdl.handle.net/1822/44877 |
Resumo: | 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. |
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A prediction rule to stratify mortality risk of patients with pulmonary tuberculosisCiências Médicas::Medicina BásicaScience & TechnologyTuberculosis 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.This work was supported by Fundacao Amelia de Mello/Jose de Mello Saude and Sociedade Portuguesa de Pneumologia (SPP). This work was developed under the scope of the project NORTE-01-0145-FEDER-000013, supported by the Northern Portugal Regional Operational Programme (NORTE 2020), under the Portugal 2020 Partnership Agreement, through the European Regional Development Fund (FEDER). NSO is a FCT (Fundacao para a Ciencia e Tecnologia) investigator. MS is an Associate FCT Investigator. The fundershad no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.Public Library of ScienceUniversidade do MinhoBastos, Hélder NovaisOsório, Nuno S.Castro, António G.Ramos, AngélicaCarvalho, TeresaMeira, LeonorAraújo, DavidAlmeida, LeonorBoaventura, RitaFragata, PatríciaChaves, CatarinaCosta, Patrício SoaresPortela, MiguelFerreira, Ivo Ricardo SilvaMagalhães, Sara PintoRodrigues, Fernando José dos SantosCastro, Rui Manuel Rosário SarmentoDuarte, RaquelGuimarães, João TiagoSaraiva, Margarida2016-092016-09-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/1822/44877engBastos, 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.01627971932-620310.1371/journal.pone.016279727636095http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0162797info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-07-21T12:52:06Zoai:repositorium.sdum.uminho.pt:1822/44877Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T19:51:09.491858Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
A prediction rule to stratify mortality risk of patients with pulmonary tuberculosis |
title |
A prediction rule to stratify mortality risk of patients with pulmonary tuberculosis |
spellingShingle |
A prediction rule to stratify mortality risk of patients with pulmonary tuberculosis Bastos, Hélder Novais Ciências Médicas::Medicina Básica Science & Technology |
title_short |
A prediction rule to stratify mortality risk of patients with pulmonary tuberculosis |
title_full |
A prediction rule to stratify mortality risk of patients with pulmonary tuberculosis |
title_fullStr |
A prediction rule to stratify mortality risk of patients with pulmonary tuberculosis |
title_full_unstemmed |
A prediction rule to stratify mortality risk of patients with pulmonary tuberculosis |
title_sort |
A prediction rule to stratify mortality risk of patients with pulmonary tuberculosis |
author |
Bastos, Hélder Novais |
author_facet |
Bastos, Hélder Novais Osório, Nuno S. Castro, António G. Ramos, Angélica Carvalho, Teresa Meira, Leonor Araújo, David Almeida, Leonor Boaventura, Rita Fragata, Patrícia Chaves, Catarina Costa, Patrício Soares Portela, Miguel Ferreira, Ivo Ricardo Silva Magalhães, Sara Pinto Rodrigues, Fernando José dos Santos Castro, Rui Manuel Rosário Sarmento Duarte, Raquel Guimarães, João Tiago Saraiva, Margarida |
author_role |
author |
author2 |
Osório, Nuno S. Castro, António G. Ramos, Angélica Carvalho, Teresa Meira, Leonor Araújo, David Almeida, Leonor Boaventura, Rita Fragata, Patrícia Chaves, Catarina Costa, Patrício Soares Portela, Miguel Ferreira, Ivo Ricardo Silva Magalhães, Sara Pinto Rodrigues, Fernando José dos Santos Castro, Rui Manuel Rosário Sarmento Duarte, Raquel Guimarães, João Tiago Saraiva, Margarida |
author2_role |
author author author author author author author author author author author author author author author author author author author |
dc.contributor.none.fl_str_mv |
Universidade do Minho |
dc.contributor.author.fl_str_mv |
Bastos, Hélder Novais Osório, Nuno S. Castro, António G. Ramos, Angélica Carvalho, Teresa Meira, Leonor Araújo, David Almeida, Leonor Boaventura, Rita Fragata, Patrícia Chaves, Catarina Costa, Patrício Soares Portela, Miguel Ferreira, Ivo Ricardo Silva Magalhães, Sara Pinto Rodrigues, Fernando José dos Santos Castro, Rui Manuel Rosário Sarmento Duarte, Raquel Guimarães, João Tiago Saraiva, Margarida |
dc.subject.por.fl_str_mv |
Ciências Médicas::Medicina Básica Science & Technology |
topic |
Ciências Médicas::Medicina Básica Science & Technology |
description |
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. |
publishDate |
2016 |
dc.date.none.fl_str_mv |
2016-09 2016-09-01T00:00:00Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/1822/44877 |
url |
http://hdl.handle.net/1822/44877 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
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 1932-6203 10.1371/journal.pone.0162797 27636095 http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0162797 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Public Library of Science |
publisher.none.fl_str_mv |
Public Library of Science |
dc.source.none.fl_str_mv |
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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