Development and validation of a prognostic score during tuberculosis treatment

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dc.contributor.authorPefura-Yone, Eric Walter
dc.contributor.authorBalkissou, Adamou Dodo
dc.contributor.authorPoka-Mayap, Virginie
dc.contributor.authorFatime-Abaicho, Hadja Koté
dc.contributor.authorEnono-Edende, Patrick Thierry
dc.contributor.authorKengne, André Pascal
dc.date.accessioned2021-10-08T06:20:29Z
dc.date.available2021-10-08T06:20:29Z
dc.date.issued2017
dc.description.abstractBACKGROUND: Death under care is a major challenge for tuberculosis (TB) treatment programs. We derived and validated a simple score to predict mortality during tuberculosis treatment in high endemicity areas. METHODS: We used data for patients aged ≥15 years, diagnosed and treated for tuberculosis at the Yaounde Jamot Hospital between January 2012 and December 2013. Baseline characteristics associated with mortality were investigated using logistic regressions. A simple prognosis score (CABI) was constructed with regression coefficients for predictors in the final model. Internal validation used bootstrap resampling procedures. Models discrimination was assessed using c-statistics and calibration assessed via calibration plots and the Hosmer and Lemeshwow (H-L) statistics. The optimal score was based on the Youden's index. RESULTS: A total of 2250 patients (men 57.2%) with a mean age of 35.8 years were included; among whom 213 deaths (cumulative incidence 9.5%) were recorded. Clinical form of tuberculosis (C), age (A, years), adjusted body mass index (B, BMI, kg/m2) and status for HIV (Human immunodefiency virus) infection (I) were significant predictors in the final model (p < 0.0001) which was of the form Death risk = 1/(1 + e - (-1.3120 + 0.0474 ∗ age - 0.1866 ∗ BMI + 1.1637 (if smear negative TB) + 0.5418(if extra - pulmonary TB) + 1.3820(if HIV+))). The c-statistic was 0.812 in the derivation sample and 0.808 after correction for optimism. The calibration was good [H-Lχ2 = 6.44 (p = 0.60)]. The optimal absolute risk threshold was 4.8%, corresponding to a sensitivity of 81% and specificity of 67%. CONCLUSIONS: The preliminary promising findings from this study require confirmation through independent external validation studies. If confirmed, the model derived could facilitate the stratification of TB patients for mortality risk and implementation of additional monitoring and management measures in vulnerable patients.
dc.identifier.apacitationPefura-Yone, E. W., Balkissou, A. D., Poka-Mayap, V., Fatime-Abaicho, H. K., Enono-Edende, P. T., & Kengne, A. P. (2017). Development and validation of a prognostic score during tuberculosis treatment. <i>BMC Infectious Diseases</i>, 17(1), 174 - 177. http://hdl.handle.net/11427/34290en_ZA
dc.identifier.chicagocitationPefura-Yone, Eric Walter, Adamou Dodo Balkissou, Virginie Poka-Mayap, Hadja Koté Fatime-Abaicho, Patrick Thierry Enono-Edende, and André Pascal Kengne "Development and validation of a prognostic score during tuberculosis treatment." <i>BMC Infectious Diseases</i> 17, 1. (2017): 174 - 177. http://hdl.handle.net/11427/34290en_ZA
dc.identifier.citationPefura-Yone, E.W., Balkissou, A.D., Poka-Mayap, V., Fatime-Abaicho, H.K., Enono-Edende, P.T. & Kengne, A.P. 2017. Development and validation of a prognostic score during tuberculosis treatment. <i>BMC Infectious Diseases.</i> 17(1):174 - 177. http://hdl.handle.net/11427/34290en_ZA
dc.identifier.issn1471-2334
dc.identifier.ris TY - Journal Article AU - Pefura-Yone, Eric Walter AU - Balkissou, Adamou Dodo AU - Poka-Mayap, Virginie AU - Fatime-Abaicho, Hadja Koté AU - Enono-Edende, Patrick Thierry AU - Kengne, André Pascal AB - BACKGROUND: Death under care is a major challenge for tuberculosis (TB) treatment programs. We derived and validated a simple score to predict mortality during tuberculosis treatment in high endemicity areas. METHODS: We used data for patients aged ≥15 years, diagnosed and treated for tuberculosis at the Yaounde Jamot Hospital between January 2012 and December 2013. Baseline characteristics associated with mortality were investigated using logistic regressions. A simple prognosis score (CABI) was constructed with regression coefficients for predictors in the final model. Internal validation used bootstrap resampling procedures. Models discrimination was assessed using c-statistics and calibration assessed via calibration plots and the Hosmer and Lemeshwow (H-L) statistics. The optimal score was based on the Youden's index. RESULTS: A total of 2250 patients (men 57.2%) with a mean age of 35.8 years were included; among whom 213 deaths (cumulative incidence 9.5%) were recorded. Clinical form of tuberculosis (C), age (A, years), adjusted body mass index (B, BMI, kg/m2) and status for HIV (Human immunodefiency virus) infection (I) were significant predictors in the final model (p < 0.0001) which was of the form Death risk = 1/(1 + e - (-1.3120 + 0.0474 ∗ age - 0.1866 ∗ BMI + 1.1637 (if smear negative TB) + 0.5418(if extra - pulmonary TB) + 1.3820(if HIV+))). The c-statistic was 0.812 in the derivation sample and 0.808 after correction for optimism. The calibration was good [H-Lχ2 = 6.44 (p = 0.60)]. The optimal absolute risk threshold was 4.8%, corresponding to a sensitivity of 81% and specificity of 67%. CONCLUSIONS: The preliminary promising findings from this study require confirmation through independent external validation studies. If confirmed, the model derived could facilitate the stratification of TB patients for mortality risk and implementation of additional monitoring and management measures in vulnerable patients. DA - 2017 DB - OpenUCT DP - University of Cape Town IS - 1 J1 - BMC Infectious Diseases LK - https://open.uct.ac.za PY - 2017 SM - 1471-2334 T1 - Development and validation of a prognostic score during tuberculosis treatment TI - Development and validation of a prognostic score during tuberculosis treatment UR - http://hdl.handle.net/11427/34290 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/34290
dc.identifier.vancouvercitationPefura-Yone EW, Balkissou AD, Poka-Mayap V, Fatime-Abaicho HK, Enono-Edende PT, Kengne AP. Development and validation of a prognostic score during tuberculosis treatment. BMC Infectious Diseases. 2017;17(1):174 - 177. http://hdl.handle.net/11427/34290.en_ZA
dc.language.isoeng
dc.publisher.departmentDepartment of Medicine
dc.publisher.facultyFaculty of Health Sciences
dc.sourceBMC Infectious Diseases
dc.source.journalissue1
dc.source.journalvolume17
dc.source.pagination174 - 177
dc.source.urihttps://dx.doi.org/10.1186/s12879-017-2309-9
dc.subject.otherMortality
dc.subject.otherPrediction
dc.subject.otherRisk score
dc.subject.otherTuberculosis
dc.subject.otherAdult
dc.subject.otherFemale
dc.subject.otherHumans
dc.subject.otherLogistic Models
dc.subject.otherMale
dc.subject.otherModels, Biological
dc.subject.otherPrognosis
dc.subject.otherRisk Assessment
dc.subject.otherRisk Factors
dc.subject.otherSeverity of Illness Index
dc.subject.otherTreatment Outcome
dc.subject.otherTuberculosis
dc.titleDevelopment and validation of a prognostic score during tuberculosis treatment
dc.typeJournal Article
uct.type.publicationResearch
uct.type.resourceJournal Article
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