Description

Foinquinos et al reported a simple score for identifying a pediatric patient with visceral leishmaniasis who is at increased risk of mortality. This is based on recalibration of the factors used to calculate the score of Sampaio et al. The authors are from Universidade Federal de Pernambuco and affiliated institutions in Recife, Brazil.


Reason for recalibration: poor performance in validation cohort. The authors conjectured that improvement in diagnosis and therapy may have contributed to a decreased lethality, requiring adjustment of weighting.

 

Patient selection: pediatric patient < 15 years old with visceral leishmaniasis

 

Parameters:

(1) dyspnea

(2) associated bacterial infection (pneumonia, gastroenteritis, sepsis, otitis media, skin abscess)

(3) absolute neutrophil count per microliter

(4) jaundice

(5) mucosal bleeding

(6) platelet count per microliter

 

Parameter

Finding

Points

dyspnea

no

0

 

yes

1

associated infections

no

0

 

yes

1

absolute neutrophil count

>= 500 per µL

0

 

< 500 per µL

1

jaundice

no

0

 

yes

1

mucosal bleeding

no

0

 

yes

1

platelet count

>= 50,000 per µL

0

 

< 50,000 per µL

1

 

total score =

= SUM(points for all of the parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 6

• A score >= 2 was associated with increased risk of mortality.

 

Performance:

• The area under the ROC curve is 0.76.


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