A simple score to predict the outcome of severe malaria in adults
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Oxford University Press
2014
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my.unimap-334672014-04-07T08:59:39Z A simple score to predict the outcome of severe malaria in adults Hanson, Josh Lee, Sue J Mohanty, Sanjib Faiz, Md Abul Anstey, Nicholas M. Charunwatthana, Prakaykaew Emran, Yunus Mishra, Saroj K Tjitra, Emiliana Price, Ric N Ridwanur, Rahman Nosten, Francois Mohammad Iqbal, Omar@Ye Htut, Assoc. Prof. Dr. Hoque, Gofranul Chau, Tran Thi Hong Phu, Nguyen Hoan Hien, Tran Tinh White, Nicholas J Day, Nicholas P J Dondorp, Arjen M drjoshhanson@gmail.com iqbalomar@unimap.edu.my Bicarbonate Acidosis Adult Article Bangladesh Brain malaria Coma acidosis malaria score Glasgow coma scale Link to publisher's homepage at http://cid.oxfordjournals.org/ Background. World Health Organization treatment guidelines recommend that adults with severe malaria be admitted to an intensive care unit (ICU). However, ICU facilities are limited in the resource-poor settings where most malaria occurs. Identification of patients at greater risk of complications may facilitate their triage and resource allocation. Methods. With use of data from a trial conducted in Southeast Asia (n = 868), a logistic regression model was built to identify independent predictors of mortality among adults with severe malaria. A scoring system based on this model was tested in the original dataset and then validated in 2 series from Bangladesh (n = 188) and Vietnam (n = 292). Results. Acidosis (base deficit) and cerebral malaria (measured as Glasgow Coma Score) were the main independent predictors of outcome. The 5-point Coma Acidosis Malaria (CAM) score was simply derived from these 2 variables. Mortality increased steadily with increasing score. A CAM score <2 predicted survival with a positive predictive value (PPV) of 95.8% (95% confidence interval [CI], 93%- 97.7%). Of the 14 of 331 patients who died with a CAM score <2, 11 (79%) had renal failure and death occurred late after hospital admission (median, 108 h; range, 40-360 h). Substitution of plasma bicarbonate as the measure of acidosis only slightly reduced the prognostic value of the model. Use of respiratory rate was inferior, but a score <2 still predicted survival with a PPV of 92.2% (95% CI, 89.1%-94.7%). Conclusions. Patients with a CAM score <2 at hospital admission may be safely treated in a general ward, provided that renal function can be monitored. 2014-04-07T08:59:39Z 2014-04-07T08:59:39Z 2010 Article Clinical Infectious Diseases, vol. 50(5), 2010, pages 679-685 1058-4838 http://dspace.unimap.edu.my:80/dspace/handle/123456789/33467 http://cid.oxfordjournals.org/content/50/5/679.full?maxtoshow=&hits=10&RESULTFORMAT=&fulltext=A+simple+score+to+predict+the+outcome+of+severe+malaria+in+adults.&searchid=1&FIRSTINDEX=0&resourcetype=HWCIT 10.1086/649928 en Oxford University Press |
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Bicarbonate Acidosis Adult Article Bangladesh Brain malaria Coma acidosis malaria score Glasgow coma scale |
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Bicarbonate Acidosis Adult Article Bangladesh Brain malaria Coma acidosis malaria score Glasgow coma scale Hanson, Josh Lee, Sue J Mohanty, Sanjib Faiz, Md Abul Anstey, Nicholas M. Charunwatthana, Prakaykaew Emran, Yunus Mishra, Saroj K Tjitra, Emiliana Price, Ric N Ridwanur, Rahman Nosten, Francois Mohammad Iqbal, Omar@Ye Htut, Assoc. Prof. Dr. Hoque, Gofranul Chau, Tran Thi Hong Phu, Nguyen Hoan Hien, Tran Tinh White, Nicholas J Day, Nicholas P J Dondorp, Arjen M A simple score to predict the outcome of severe malaria in adults |
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Link to publisher's homepage at http://cid.oxfordjournals.org/ |
| author2 |
drjoshhanson@gmail.com |
| author_facet |
drjoshhanson@gmail.com Hanson, Josh Lee, Sue J Mohanty, Sanjib Faiz, Md Abul Anstey, Nicholas M. Charunwatthana, Prakaykaew Emran, Yunus Mishra, Saroj K Tjitra, Emiliana Price, Ric N Ridwanur, Rahman Nosten, Francois Mohammad Iqbal, Omar@Ye Htut, Assoc. Prof. Dr. Hoque, Gofranul Chau, Tran Thi Hong Phu, Nguyen Hoan Hien, Tran Tinh White, Nicholas J Day, Nicholas P J Dondorp, Arjen M |
| format |
Article |
| author |
Hanson, Josh Lee, Sue J Mohanty, Sanjib Faiz, Md Abul Anstey, Nicholas M. Charunwatthana, Prakaykaew Emran, Yunus Mishra, Saroj K Tjitra, Emiliana Price, Ric N Ridwanur, Rahman Nosten, Francois Mohammad Iqbal, Omar@Ye Htut, Assoc. Prof. Dr. Hoque, Gofranul Chau, Tran Thi Hong Phu, Nguyen Hoan Hien, Tran Tinh White, Nicholas J Day, Nicholas P J Dondorp, Arjen M |
| author_sort |
Hanson, Josh |
| title |
A simple score to predict the outcome of severe malaria in adults |
| title_short |
A simple score to predict the outcome of severe malaria in adults |
| title_full |
A simple score to predict the outcome of severe malaria in adults |
| title_fullStr |
A simple score to predict the outcome of severe malaria in adults |
| title_full_unstemmed |
A simple score to predict the outcome of severe malaria in adults |
| title_sort |
simple score to predict the outcome of severe malaria in adults |
| publisher |
Oxford University Press |
| publishDate |
2014 |
| url |
http://dspace.unimap.edu.my:80/dspace/handle/123456789/33467 |
| _version_ |
1643797193200500736 |
| score |
13.209306 |