Establishment of a novel scoring model for mortality risk prediction in HIV-infected patients with cryptococcal meningitis

BMC Infectious Diseases

Tong-Tong Yang¹  Shui-Qing Liu²  Xuan Yang³  Xiao-Hong Chen⁴  Ting Zhao⁵  Vijay Harypursat⁵  Yan-Qiu Lu⁵  Jing-Min Nie⁵  Feng Sun⁵  Yao-Kai Chen⁵  Xiao-Lei Xu⁵  Zhong-Sheng Jiang⁶ 

[1] Department of Infectious Disease, Public Health Clinical Center of Chengdu;Department of Infectious Diseases, Guiyang Public Health Clinical Center;Department of Infectious Diseases, Sixth People’s Hospital of Zhengzhou;Department of Infectious Diseases, The Fourth Affiliated Hospital of Harbin Medical University;Division of Infectious Diseases, Chongqing Public Health Medical Center;Division of Infectious Diseases, Liuzhou People’s Hospital;

关键词: HIV;    Cryptococcal meningitis;    Risk factors;    Mortality;    Scoring model;   

DOI  :  10.1186/s12879-021-06417-9

来源: DOAJ

【 摘 要 】

Abstract Background Cryptococcal meningitis (CM) remains a leading cause of death in HIV-infected patients, despite advances in CM diagnostic and therapeutic strategies. This study was performed with the aim to develop and validate a novel scoring model to predict mortality risk in HIV-infected patients with CM (HIV/CM). Methods Data on HIV/CM inpatients were obtained from a Multicenter Cohort study in China. Independent risk factors associated with mortality were identified based on data from 2013 to 2017, and a novel scoring model for mortality risk prediction was established. The bootstrapping statistical method was used for internal validation. External validation was performed using data from 2018 to 2020. Results We found that six predictors, including age, stiff neck, impaired consciousness, intracranial pressure, CD4+ T-cell count, and urea levels, were associated with poor prognosis in HIV/CM patients. The novel scoring model could effectively identify HIV/CM patients at high risk of death on admission (area under curve 0.876; p<0.001). When the cut-off value of 5.5 points or more was applied, the sensitivity and specificity was 74.1 and 83.8%, respectively. Our scoring model showed a good discriminatory ability, with an area under the curve of 0.879 for internal validation via bootstrapping, and an area under the curve of 0.886 for external validation. Conclusions Our developed scoring model of six variables is simple, convenient, and accurate for screening high-risk patients with HIV/CM, which may be a useful tool for physicians to assess prognosis in HIV/CM inpatients.

【 授权许可】

Unknown