A risk prediction score for invasive mold disease in patients with hematological malignancies
| Autor: | Fabio Tumietto, Mauro Fiacchini, Pierluigi Viale, Nicola Vianelli, Marta Stanzani, Russell E. Lewis, Michele Cavo, Paolo Ricci, Simone Ambretti, Michele Baccarani |
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| Přispěvatelé: | Stanzani M, Lewis RE, Fiacchini M, Ricci P, Tumietto F, Viale P, Ambretti S, Baccarani M, Cavo M, Vianelli N |
| Jazyk: | angličtina |
| Rok vydání: | 2013 |
| Předmět: |
Adult
Male Risk medicine.medical_specialty mold infection Antifungal Agents Adolescent medicine.medical_treatment lcsh:Medicine Hematopoietic stem cell transplantation Disease Neutropenia risk score HEMATOLOGICAL MALIGNANCIES Young Adult IMD Pregnancy Risk Factors Internal medicine Epidemiology medicine Humans lcsh:Science Aged Retrospective Studies Aged 80 and over Univariate analysis Multidisciplinary Framingham Risk Score business.industry lcsh:R Fungi Retrospective cohort study Middle Aged medicine.disease Surgery Mycoses Hematologic Neoplasms Female lcsh:Q Lymphocytopenia business Research Article |
| Zdroj: | PLoS ONE, Vol 8, Iss 9, p e75531 (2013) PLoS ONE |
| ISSN: | 1932-6203 |
| Popis: | BACKGROUND: A risk score for invasive mold disease (IMD) in patients with hematological malignancies could facilitate patient screening and improve the targeted use of antifungal prophylaxis. METHODS: We retrospectively analyzed 1,709 hospital admissions of 840 patients with hematological malignancies (2005-2008) to collect data on 17 epidemiological and treatment-related risk factors for IMD. Multivariate regression was used to develop a weighted risk score based on independent risk factors associated with proven or probable IMD, which was prospectively validated during 1,746 hospital admissions of 855 patients from 2009-2012. RESULTS: Of the 17 candidate variables analyzed, 11 correlated with IMD by univariate analysis, but only 4 risk factors (neutropenia, lymphocytopenia or lymphocyte dysfunction in allogeneic hematopoietic stem cell transplant recipients, malignancy status, and prior IMD) were retained in the final multivariate model, resulting in a weighted risk score 0-13. A risk score of < 6 discriminated patients with low (< 1%) versus higher incidence rates (> 5%) of IMD, with a negative predictive value (NPV) of 0.99, (95% CI 0.98-0.99). During 2009-2012, patients with a calculated risk score at admission of < 6 had significantly lower 90-day incidence rates of IMD compared to patients with scores > 6 (0.9% vs. 10.6%, P |
| Databáze: | OpenAIRE |
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