Development and validation of a tuberculosis prognostic score for smear-positive in-patients in Japan
OBJECTIVE: To develop and validate a tuberculosis prognostic score.
METHODS: This retrospective cohort study conducted in Japan comprised the development (n = 179; mean age 65.9 ± 18.8 years) and validation (n = 244; mean age 64.3 ± 20.1 years) of a tuberculosis prognostic score among patients with newly diagnosed smear-positive non-multidrug-resistant pulmonary tuberculosis without human immunodeficiency virus infection. The score (raw score) was defined by modifying a logistic regression formula using known risk factors as independent variables and in-patient death as a dependent variable.
RESULTS: The raw score was calculated as follows: age (years) + (oxygen requirement, 10 points) − 20 × albumin (g/dl) + (activity of daily living: independent, 0 point; semi-dependent, 5 points; totally dependent, 10 points). The raw scores were grouped into risk groups 1 (raw score < −30) to 5 (raw score ≥ 60) using 30-point intervals. Every increase in risk group was equivalent to a 7.3-fold increase in the odds ratio for in-hospital death (P < 0.001). The area under the receiver operating characteristics curve by risk group for in-patient death was 0.875 (P < 0.001).
CONCLUSIONS: In this study we were able to develop and validate a tuberculosis prognostic score.
Keywords: activities of daily living; albumin; elderly; malnutrition
Document Type: Research Article
Affiliations: 1: Department of Internal Medicine and Clinical Immunology, Yokohama City University Graduate School of Medicine, Yokohama, Japan 2: Department of Respiratory Medicine, Saiseikai Yokohamashi Nanbu Hospital, Yokohama, Japan 3: Department of Respiratory Medicine, Fukujuji Hospital, Tokyo, Japan 4: Department of Biostatistics and Epidemiology, Yokohama City University Medical Center, Yokohama, Japan 5: Respiratory Disease Center, Yokohama City University Medical Center, Yokohama, Japan
Publication date: 01 January 2013
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