Clinical Prediction Rules for In-Hospital Mortality Outcome in Melioidosis Patients
Abstract
:1. Introduction
2. Materials and Methods
2.1. Participants
2.2. Outcomes
2.3. Predictors
2.4. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Characteristics | Missing n (%) | Non-Survival (n = 125) | Survival (n = 157) | p-Value |
---|---|---|---|---|
Male 1, n (%) | 0 | 89 (71.2) | 118 (75.2) | 0.499 |
Age (years) 2, mean ± SD | 0 | 59.0 ± 15.5 | 55.0 ± 13.2 | 0.022 |
Age ≥ 60 years 1, n (%) | 68 (54.4) | 62 (39.5) | 0.016 | |
Comorbid at least 1 disease 1, n (%) | 0 | 100 (80.0) | 127 (80.9) | 1.881 |
Comorbid 1, n (%) (DM/CKD/Cirrhosis/Thalassemia) | 0 | 75 (60.0) | 100 (63.7) | 0.539 |
qSOFA score 3, median (IQR) | 0 | 1 (1–2) | 1 (0–1) | <0.001 |
qSOFA score ≥ 2 1, n (%) | 49 (39.2) | 17 (10.8) | <0.001 | |
SIRS score 2, mean ± SD | 2 (0.7) | 2.9 ± 0.9 | 2.5 ± 1.1 | 0.002 |
SIRS score ≥ 2 1, n (%) | 115 (92.0) | 125 (80.7) | 0.009 | |
Body mass index 2, mean ± SD | 19 (6.7) | 20.5 ± 3.7 | 21.5 ± 3.8 | 0.025 |
Clinical syndromes 1, n (%) | 0 | <0.001 | ||
Localized or bacteremia * | 35 (28.0) | 80 (51.0) | ||
Disseminated form ** | 90 (72.0) | 77 (49.0) | ||
Abnormal chest X-ray finding 1, n (%) | 2 (0.7) | 106 (85.5) | 71 (45.5) | <0.001 |
%Neutrophils 2, mean ± SD | 3 (1.1) | 85.5 ± 11.2 | 81.6 ± 10.7 | 0.003 |
%Neutrophils ≥ 851, n (%) | 81 (64.8) | 61 (39.6) | <0.001 | |
Platelet, cells/mm3 3, median (IQR) | 2 (0.7) | 163,000 (84,000–219,000) | 213,000 (151,000–323,000) | <0.001 |
Platelet < 100,000 cells/mm3 1, n (%) | 37 (29.6) | 16 (10.3) | <0.001 | |
BUN, mg/dL3, median (IQR) | 3 (1.1) | 37 (22–59) | 17 (12–28) | <0.001 |
BUN ≥ 20 mg/dL 1, n (%) | 97 (77.6) | 61 (39.6) | <0.001 | |
Creatinine, mg/dL 3, median (IQR) | 4 (1.4) | 2.1 (1.2–3.4) | 1.1 (0.8–1.6) | <0.001 |
Creatinine ≥ 1.5 mg/dL1, n (%) | 79 (63.7) | 44 (28.6) | <0.001 | |
AST, U/L 3, median (IQR) | 24 (8.5) | 109 (61–261) | 55 (36–98.5) | <0.001 |
AST ≥ 50 U/L 1, n (%) | 101 (85.6) | 78 (55.7) | <0.001 | |
Albumin, g/dL 2, mean ± SD | 23 (8.2) | 2.5 ± 0.6 | 2.8 ± 0.6 | <0.001 |
Albumin ≤ 3 g/dL 1, n (%) | 97 (81.5) | 85 (60.7) | <0.001 | |
HCO3, mEq/L 2, mean ± SD | 5 (1.8) | 17.3 ± 6.5 | 22.1 ± 5.6 | <0.001 |
HCO3 ≤ 20 mEq/L 1, n (%) | 86 (69.4) | 42 (27.5) | <0.001 |
Parameters | Univariable OR | 95% CI of uOR | p-Value | Multivariable OR | 95% CI of mOR | p-Value |
---|---|---|---|---|---|---|
qSOFA score ≥ 2 | 5.31 | 2.86–9.85 | <0.001 | 2.39 | 1.12–5.11 | 0.025 |
Abnormal Chest X-ray | 7.05 | 3.91–12.73 | <0.001 | 5.86 | 2.79–12.29 | <0.001 |
Creatinine ≥ 1.5 mg/dL | 4.39 | 2.65–7.28 | <0.001 | 2.80 | 1.38–5.69 | 0.004 |
AST ≥ 50 U/L | 4.72 | 2.56–8.71 | <0.001 | 4.03 | 1.93–8.42 | <0.001 |
HCO3 ≤ 20 mEq/L | 5.98 | 3.55–10.07 | <0.001 | 2.96 | 1.48–5.92 | 0.002 |
Diagnostic Parameter | Coefficients | Transformed Coefficient | Assigned Score |
---|---|---|---|
qSOFA ≥ 2 | |||
No | - | - | 0 |
Yes | 0.87 | 1 | 1 |
Abnormal Chest X-ray | |||
No | - | - | 0 |
Yes | 1.77 | 2.03 | 2 |
Creatinine ≥ 1.5 mg/dL | |||
No | - | - | 0 |
Yes | 1.03 | 1.18 | 1 |
AST ≥ 50 U/L | |||
No | - | - | 0 |
Yes | 1.39 | 1.60 | 2 |
HCO3 ≤ 20 mEq/L | |||
No | - | - | 0 |
Yes | 1.08 | 1.25 | 1 |
Risk Level | Fetal Melioidosis (%) | Non-Fatal Melioidosis (%) | PPV (%) | LR+ | 95% CI of LR+ | p-Value |
---|---|---|---|---|---|---|
Low (score 0–3) | 12 (13.0) | 80 (87.0) | 13.0 | 0.18 | 0.10–0.31 | <0.001 |
High (score 4–7) | 104 (65.0) | 56 (35.0) | 65.0 | 2.18 | 1.76–2.69 | <0.001 |
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Chayangsu, S.; Suankratay, C.; Tantraworasin, A.; Khorana, J. Clinical Prediction Rules for In-Hospital Mortality Outcome in Melioidosis Patients. Trop. Med. Infect. Dis. 2024, 9, 146. https://doi.org/10.3390/tropicalmed9070146
Chayangsu S, Suankratay C, Tantraworasin A, Khorana J. Clinical Prediction Rules for In-Hospital Mortality Outcome in Melioidosis Patients. Tropical Medicine and Infectious Disease. 2024; 9(7):146. https://doi.org/10.3390/tropicalmed9070146
Chicago/Turabian StyleChayangsu, Sunee, Chusana Suankratay, Apichat Tantraworasin, and Jiraporn Khorana. 2024. "Clinical Prediction Rules for In-Hospital Mortality Outcome in Melioidosis Patients" Tropical Medicine and Infectious Disease 9, no. 7: 146. https://doi.org/10.3390/tropicalmed9070146