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Free Content Development and validation of a tuberculosis prognostic score for smear-positive in-patients in Japan

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BACKGROUND: No scoring system has ever been used to estimate the prognosis of individual tuberculosis (TB) patients.

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.
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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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  • The International Journal of Tuberculosis and Lung Disease (IJTLD) is for clinical research and epidemiological studies on lung health, including articles on TB, TB-HIV and respiratory diseases such as COVID-19, asthma, COPD, child lung health and the hazards of tobacco and air pollution. Individuals and institutes can subscribe to the IJTLD online or in print – simply email us at [email protected] for details.

    The IJTLD is dedicated to understanding lung disease and to the dissemination of knowledge leading to better lung health. To allow us to share scientific research as rapidly as possible, the IJTLD is fast-tracking the publication of certain articles as preprints prior to their publication. Read fast-track articles.

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