Published in:
Open Access 01-12-2019 | Tuberculosis | Research article
Development and validation of a risk score to predict mortality during TB treatment in patients with TB-diabetes comorbidity
Published in: BMC Infectious Diseases | Issue 1/2019
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Background
Making an accurate prognosis for mortality during tuberculosis (TB) treatment in TB-diabetes (TB-DM) comorbid patients remains a challenge for health professionals, especially in low TB prevalent populations, due to the lack of a standardized prognostic model.
Methods
Using de-identified data from TB-DM patients from Texas, who received TB treatment had a treatment outcome of completed treatment or died before completion, reported to the National TB Surveillance System from January 2010–December 2016, we developed and internally validated a mortality scoring system, based on the regression coefficients.
Results
Of 1227 included TB-DM patients, 112 (9.1%) died during treatment. The score used nine characteristics routinely collected by most TB programs. Patients were divided into three groups based on their score: low-risk (< 12 points), medium-risk (12–21 points) and high-risk (≥22 points). The model had good performance (with an area under the receiver operating characteristic (ROC) curve of 0.83 in development and 0.82 in validation), and good calibration. A practical mobile calculator app was also created (https://oaa.app.link/Isqia5rN6K).
Conclusion
Using demographic and clinical characteristics which are available from most TB programs at the patient’s initial visits, our simple scoring system had good performance and may be a practical clinical tool for TB health professionals in identifying TB-DM comorbid patients with a high mortality risk.