Utilize este identificador para referenciar este registo:
https://hdl.handle.net/1822/44877
Título: | A prediction rule to stratify mortality risk of patients with pulmonary tuberculosis |
Autor(es): | 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 |
Data: | Set-2016 |
Editora: | Public Library of Science |
Revista: | PLoS ONE |
Citação: | 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 |
Resumo(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. |
Tipo: | Artigo |
URI: | https://hdl.handle.net/1822/44877 |
DOI: | 10.1371/journal.pone.0162797 |
ISSN: | 1932-6203 |
Versão da editora: | http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0162797 |
Arbitragem científica: | yes |
Acesso: | Acesso aberto |
Aparece nas coleções: | ICVS - Artigos em revistas internacionais / Papers in international journals |
Ficheiros deste registo:
Ficheiro | Descrição | Tamanho | Formato | |
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untitled.pdf | 1,16 MB | Adobe PDF | Ver/Abrir |