Department of Internal Medicine and Clinical Immunology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
Int J Tuberc Lung Dis. 2013 Jan;17(1):54-60. doi: 10.5588/ijtld.12.0476.
No scoring system has ever been used to estimate the prognosis of individual tuberculosis (TB) patients.
To develop and validate a tuberculosis prognostic score.
This retrospective cohort study conducted in Japan comprised the development (n = 179; mean age 65.9 ± 18.8 years) and validation (n = 244; mean age 64.3 ± 20.1 years) of a tuberculosis prognostic score among patients with newly diagnosed smear-positive non-multidrug-resistant pulmonary tuberculosis without human immunodeficiency virus infection. The score (raw score) was defined by modifying a logistic regression formula using known risk factors as independent variables and in-patient death as a dependent variable.
The raw score was calculated as follows: age (years) + (oxygen requirement, 10 points) - 20 × albumin (g/dl) + (activity of daily living: independent, 0 point; semi-dependent, 5 points; totally dependent, 10 points). The raw scores were grouped into risk groups 1 (raw score < -30) to 5 (raw score ≥ 60) using 30-point intervals. Every increase in risk group was equivalent to a 7.3-fold increase in the odds ratio for in-hospital death (P < 0.001). The area under the receiver operating characteristics curve by risk group for in-patient death was 0.875 (P < 0.001).
In this study we were able to develop and validate a tuberculosis prognostic score.
目前尚无评分系统用于评估个体结核病患者的预后。
开发并验证一种结核病预后评分系统。
本研究为回顾性队列研究，在日本进行，纳入了新诊断为痰涂片阳性、非耐多药的肺结核且未感染人类免疫缺陷病毒的患者。在该研究中，我们通过对使用已知危险因素作为自变量、住院死亡作为因变量的逻辑回归公式进行修正，定义了一个评分（原始评分）。
原始评分的计算方法如下：年龄（岁）+（氧需求，10 分）-20×白蛋白（g/dl）+（日常生活活动能力：独立，0 分；半依赖，5 分；完全依赖，10 分）。原始评分采用 30 分间隔分组为风险组 1（原始评分＜-30）至 5（原始评分≥60）。风险组每增加一组，住院死亡的比值比增加 7.3 倍（P＜0.001）。风险组预测住院死亡的受试者工作特征曲线下面积为 0.875（P＜0.001）。
本研究成功开发并验证了一种结核病预后评分系统。
