Abongomera et al reported a clinical prognostic score for patients with visceral leishmaniasis. This can help to identify a patient who may benefit from more aggressive management. The authors are from Institute of Tropical Medicine (Antwerp), Medecins Sans Frontieres (Amsterdam) and University of Gondar (Ethiopia).
Patient selection: visceral leishmaniasis
Outcome: mortality
Parameters:
(1) age in years
(2) HIV serostatus
(3) hemoglobin in g/dL
(4) bleeding
(5) jaundice
(6) edema
(7) ascites
(8) tuberculosis
Parameter
Finding
Points
age in years
<= 40 years
0
> 40 years
1
HIV serostatus
negative
-1
positive
1
hemoglobin
<= 6.5 g/dL
1
> 6.5 g/dL
0
bleeding
no
0
yes
1
jaundice
no
0
yes
1
edema
no
0
yes
1
ascites
no
0
yes
2
tuberculosis
no
0
yes
1
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: -1
• maximum score: 9
Total Score
Mortality
-1
1%
0
4%
1
10%
2
19%
3
31%
4
50%
5
86%
Performance:
• The area under the ROC curve is 0.83 in derivation and 0.78 in validation cohorts.
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