Risk factors for physical disability upon release from multidrug therapy in new cases of leprosy at a referral center in Brazil
| Autor: | Sandra Lyon, Bárbara Proença Nardi Assis, Maria Aparecida de Faria Grossi, Manoel Otávio da Costa Rocha |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty lcsh:Arctic medicine. Tropical medicine Complications Physical disability Multivariate analysis lcsh:RC955-962 030231 tropical medicine Leprostatic Agents Severity of Illness Index Disability Evaluation 03 medical and health sciences 0302 clinical medicine Pharmacotherapy Leprosy Severity of illness medicine Humans Disabled Persons Longitudinal Studies Risk factor Referral and Consultation Aged Retrospective Studies business.industry Retrospective cohort study Middle Aged medicine.disease Socioeconomic Factors Risk factors Physical therapy Original Article Drug Therapy Combination Female Ordered logit business Brazil |
| Zdroj: | Revista do Instituto de Medicina Tropical de São Paulo, Volume: 61, Article number: e13, Published: 14 FEB 2019 Revista do Instituto de Medicina Tropical de São Paulo Revista do Instituto de Medicina Tropical de São Paulo; Vol. 61 (2019); e13 Revista do Instituto de Medicina Tropical de São Paulo; v. 61 (2019); e13 Instituto de Medicina Tropical (IMT) instacron:IMT Revista do Instituto de Medicina Tropical de São Paulo, Vol 61, Iss 0 (2019) |
| ISSN: | 1678-9946 0036-4665 |
| Popis: | The present study sought to investigate the risk factors for physical disability upon release from multidrug therapy (MDT) in new cases of leprosy, registered at a referral center in Brazil. This is a longitudinal and retrospective study that evaluated 260 patients. Multivariate analyses, using both the ordinal logistic regression, as well as the classification and regression tree (CART) algorithm were performed to determine the factors associated with physical disability upon release from treatment. The prevalence of disability did not differ significantly between diagnosis and release from treatment. Number of affected nerves and sensory impairment upon diagnosis were risk factors for disability at the end of MDT. The analysis using the CART algorithm resulted in the development of a clinical score to predict the risk of disability upon release from MDT. The decision tree may have a direct applicability in clinical practice for professionals dealing with leprosy, as it allows them to identify patients with a higher risk of physical disability through the use of simple and widely available clinical tests. This study also shows that the disability grade upon admission is the main risk factor for disability upon release from MDT. This result draws attention to the importance of early diagnosis in disability prevention. |
| Databáze: | OpenAIRE |
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