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A proposed scoring system for predicting mortality in melioidosis

Cheng, Allen C., Jacups, Susan Patricia, Anstey, Nicholas M. and Currie, Bart J. (2003). A proposed scoring system for predicting mortality in melioidosis. Transactions of the Royal Society of Tropical Medicine and Hygiene,97(5):577-581.

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Title A proposed scoring system for predicting mortality in melioidosis
Author Cheng, Allen C.
Jacups, Susan Patricia
Anstey, Nicholas M.
Currie, Bart J.
Journal Name Transactions of the Royal Society of Tropical Medicine and Hygiene
Publication Date 2003
Volume Number 97
Issue Number 5
ISSN 0035-9203   (check CDU catalogue open catalogue search in new window)
Start Page 577
End Page 581
Total Pages 5
Place of Publication Oxford
Publisher Elsevier
1108 - Medical Microbiology
1117 - Public Health and Health Services
0699 - Other Biological Sciences
HERDC Category C1 - Journal Article (DEST)
Abstract Melioidosis, due to infection with the environmental organism Burkholderia pseudomallei, continues to be associated with high mortality despite improvements in antibiotic therapy. Using simple clinical findings and baseline laboratory tests available at the time of admission, we attempted to define those patients with acute melioidosis who were at higher risk of death. Using data, collected prospectively from the period October 1989 to June 2002, from patients with acute culture-confirmed melioidosis presenting at the Royal Darwin Hospital, Darwin, Australia, a number of variables were selected that were easily available at the time of admission and reflected organ dysfunction. Mortality was predicted in univariate logistic and multivariate models by the presence of pneumonia, age at diagnosis, serum urea, serum bilirubin, lymphocyte count, and serum bicarbonate. A score was assigned from 0 to 2, based on the degree of abnormality. A melioidosis score was formed from the sum of these scores, with a maximum score of 11. A score of ≤ 3 (n = 140) was associated with a mortality of 8.6%, whereas a score of ≥ 4 (n = 112) was associated with a mortality of 44.6%. Although this scoring system requires external validation, it may help identify a suitable target group of patients for intensive intervention such as early admission to an intensive care unit, the early use of meropenem, and goal-directed resuscitation therapies.
Keywords melioidosis
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Created: Mon, 17 Dec 2007, 09:02:11 CST