Li et al reported a model for predicting 2-year mortality for a patient hospitalized with advanced schistosomiasis. This can help to identify a patient who may require more aggressive management. The authors are from Huazhong University of Science and Technology in Wuhan, China.
Patient selection: hospitalized for advanced schistosomiasis
Parameters:
(1) age in years
(2) clinical assessment
(3) serum direct bilirubin
(4) serum AST
(5) serum alkaline phosphatase
(6) HBsAg reactivity
(7) serum alpha-fetoprotein
Parameter
Finding
Points
age in years
< 50 years
1
50 to 59 years
2
60 to 69 years
3
70 to 79 years
4
>= 80 years
5
clinical assessment
ascites
0
splenomegaly
1
direct bilirubin
normal
0
abnormal
1
AST
normal
0
abnormal
1
alkaline phophatase
normal
0
abnormal
1
HBsAg
negative
0
positive
1
alpha-fetoprotein
normal
0
abnormal
1
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 1
• maximum score: 11
• The higher the score the greater the 2-year mortality.
Total Score
2-Year Mortality
1
0.7%
2
1.4%
3
2.8%
4
5.5%
5
10.7%
6
20%
7
35%
8
52%
9
67%
Performance:
• The area under the ROC curve is 0.76 for internal and 0.72 for external validation cohorts.
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