Dendle et al reported a score for predicting severe infection within 2 years for a renal transplant patient. This can help to identify a high-risk patient who may benefit from more aggressive management. The authors are from Monash University and Peter MacCallum Cancer Centre in Australia.
Patient selection: renal transplant
Outcome: severe infection in the next 2 years
Parameters:
(1) mycophenolate use
(2) eGFR in mL per min per square meter
(3) absolute CD4+ cell count per mL (reference range 389 to 1.569)
(4) absolute natural killer (NK) cell count per mL (reference range 61 to 776)
Parameter
Finding
Points
mycophenolate use
no
0
yes
6
eGFR
-1.2 * (eGFR) / 10
absolute CD4+
-0.5 * (CD4+) / 100
absolute NK cell
-1.7 * (NK) / 100
where:
• The absolute cell counts are reported per mL. This does not appear to be referring to microliters.
level of immunosuppression score =
= SUM(points for all of the parameters) + 18
Interpretation:
• minimum score: 0
• maximum score: 20.
• The higher the score the greater the risk of severe infection.
Score
Risk of Severe Infection
0 to 5
12%
5.1 to 10
21%
10.1 to 15
44%
15.1 to 20
84%
Performance:
• The area under the ROC curve is 0.75.
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