Derivation and validation of a universal vital assessment (UVA) score: a tool for predicting mortality in adult hospitalised patients in sub-Saharan Africa
| Autor: | Matthew P. Rubach, Martin Otyek Opio, Shabir Lakhi, Albert Majwala, John A. Crump, Abdallah Amir, Martin P. Grobusch, Laura E. Barnes, Patrick Banura, Christopher C. Moore, John E. Ainsworth, Shevin T. Jacob, John S. Schieffelin, Riley Hazard, Tim Baker, India Wheeler, W. Michael Scheld, Richard Ssekitoleko, John Kellett, Michaëla A. M. Huson, Jamie Rylance, Olamide D Jarrett, Susan A Adakun, Ben Andrews, Kacie J Saulters, Mary A Auma |
|---|---|
| Přispěvatelé: | AII - Infectious diseases, APH - Global Health, Infectious diseases, APH - Aging & Later Life, AII - Amsterdam institute for Infection and Immunity |
| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
Pediatrics early warning score 030231 tropical medicine wa_395 MEWS 03 medical and health sciences qSOFA 0302 clinical medicine Internal medicine Journal Article medicine critical illness 030212 general & internal medicine f0e481db hospital mortality Receiver operating characteristic business.industry Research Health Policy wa_900 Public Health Environmental and Occupational Health Glasgow Coma Scale Early warning score Triage 3. Good health bf023de6 Mews Blood pressure Africa business Serostatus Cohort study |
| Zdroj: | BMJ global health, 2(2). BMJ Publishing Group Moore, C C, Hazard, R, Saulters, K J, Ainsworth, J, Adakun, S A, Amir, A, Andrews, B, Auma, M, Baker, T, Banura, P, Crump, J A, Grobusch, M P, Huson, M A M, Jacob, S T, Jarrett, O D, Kellett, J, Lakhi, S, Majwala, A, Opio, M, Rubach, M P, Rylance, J, Michael Scheld, W, Schieffelin, J, Ssekitoleko, R, Wheeler, I & Barnes, L E 2017, ' Derivation and validation of a universal vital assessment (UVA) score : a tool for predicting mortality in adult hospitalised patients in sub-Saharan Africa ', B M J Global Health, vol. 2, no. 2, e000344 . https://doi.org/10.1136/bmjgh-2017-000344 BMJ Global Health |
| ISSN: | 2059-7908 |
| DOI: | 10.1136/bmjgh-2017-000344 |
| Popis: | BACKGROUND: Critical illness is a leading cause of morbidity and mortality in sub-Saharan Africa (SSA). Identifying patients with the highest risk of death could help with resource allocation and clinical decision making. Accordingly, we derived and validated a universal vital assessment (UVA) score for use in SSA.METHODS: We pooled data from hospital-based cohort studies conducted in six countries in SSA spanning the years 2009-2015. We derived and internally validated a UVA score using decision trees and linear regression and compared its performance with the modified early warning score (MEWS) and the quick sepsis-related organ failure assessment (qSOFA) score.RESULTS: Of 5573 patients included in the analysis, 2829 (50.8%) were female, the median (IQR) age was 36 (27-49) years, 2122 (38.1%) were HIV-infected and 996 (17.3%) died in-hospital. The UVA score included points for temperature, heart and respiratory rates, systolic blood pressure, oxygen saturation, Glasgow Coma Scale score and HIV serostatus, and had an area under the receiver operating characteristic curve (AUC) of 0.77 (95% CI 0.75 to 0.79), which outperformed MEWS (AUC 0.70 (95% CI 0.67 to 0.71)) and qSOFA (AUC 0.69 (95% CI 0.67 to 0.72)).CONCLUSION: We identified predictors of in-hospital mortality irrespective of the underlying condition(s) in a large population of hospitalised patients in SSA and derived and internally validated a UVA score to assist clinicians in risk-stratifying patients for in-hospital mortality. The UVA score could help improve patient triage in resource-limited environments and serve as a standard for mortality risk in future studies. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|