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spelling 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
institution Universiti Malaysia Perlis
building UniMAP Library
collection Institutional Repository
continent Asia
country Malaysia
content_provider Universiti Malaysia Perlis
content_source UniMAP Library Digital Repository
url_provider http://dspace.unimap.edu.my/
language English
topic Bicarbonate
Acidosis
Adult
Article
Bangladesh
Brain malaria
Coma acidosis malaria score
Glasgow coma scale
spellingShingle 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
description 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 13.214268