Coura-Vital et al reported a score for predicting mortality from visceral leishmaniasis in Brazil. This can help to identify a patient who may benefit from more aggressive management. The authors are from multiple institutions in Brazil.
Patient selection: visceral leishmaniasis
Parameters:
(1) splenomegaly
(2) edema
(3) weakness
(4) bleeding
(5) jaundice
(6) age in years
(7) HIV co-infection
(8) bacterial infection
Parameters
Finding
Points
splenomegaly
no
0
yes
1
edema
no
0
yes
1
weakness
no
0
yes
1
bleeding
no
0
yes
3
jaundice
no
0
yes
1
HIV
no
0
yes
1
bacterial infection
no
0
yes
1
age
<= 0.5 years
5
0.51 to 1 year
2
1.01 to 19 years
0
19.01 to 50 years
2
50.01 to 64.99 years
3
>= 65 years
5
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 14
Score
Mortality Rate
0
0.6%
1
0.9 to 1.1%
2
1.5 to 1.9%
3
2.2 to 3.2%
4
3.4 to 5.2%
5
4.8 to 8.3%
6
7.2 to 13%
7
11.2 to 19.5%
8
16.2 to 27.1%
9
23 to 33.8%
10
32.5 to 45.3%
11
44.3 to 56%
12
56.7 to 66.2%
13
69.8 to 76%
14
81.3 to 82.9%
Performance:
• The area under the ROC curve is 0.80 in the derivation and 0.78 in the validation cohorts.
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