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A Prediction Rule to Stratify Mortality Risk of Patients with Pulmonary Tuberculosis

2016Journal article Open access
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dc.contributor.authorBastos, H.
dc.contributor.authorOsório, N.
dc.contributor.authorCastro, A.
dc.contributor.authorRamos, A.
dc.contributor.authorCarvalho, T.
dc.contributor.authorMeira, L.
dc.contributor.authorAraújo, D.
dc.contributor.authorAlmeida, L.
dc.contributor.authorBoaventura, R.
dc.contributor.authorFragata, P.
dc.contributor.authorChaves, C.
dc.contributor.authorCosta, P.
dc.contributor.authorPortela, M.
dc.contributor.authorFerreira, I.
dc.contributor.authorMagalhães, S.
dc.contributor.authorRodrigues, F.
dc.contributor.authorSarmento-Castro, R.
dc.contributor.authorDuarte, R.
dc.contributor.authorGuimarães, J.
dc.contributor.authorSaraiva, M.
dc.date.accessioned2017-07-11T14:15:14Z
dc.date.available2017-07-11T14:15:14Z
dc.date.issued2016
dc.description.abstractTuberculosis 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 1.4-4.4), ≥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.pt_PT
dc.description.sponsorshipThis work was supported by Fundação Amélia de Mello/José de Mello Saúde 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 (Fundação para a Ciência e Tecnologia) investigator. MS is an Associate FCT Investigator. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationPLoS One. 2016;11(9):e016279pt_PT
dc.identifier.doi10.1371/journal.pone.0162797pt_PT
dc.identifier.issn1932-6203
dc.identifier.urihttp://hdl.handle.net/10400.16/2149
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherPublic Library of Sciencept_PT
dc.relationNORTE-01-0145-FEDER-000013pt_PT
dc.relation.publisherversionhttp://journals.plos.org/plosone/article?id=10.1371/journal.pone.0162797pt_PT
dc.titleA Prediction Rule to Stratify Mortality Risk of Patients with Pulmonary Tuberculosispt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.conferencePlaceUnited States of Americapt_PT
oaire.citation.issue9pt_PT
oaire.citation.startPagee0162797pt_PT
oaire.citation.titlePLoS ONEpt_PT
oaire.citation.volume11pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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