A risk scoring system to identify travellers who qualify for pre-exposure rabies vaccination

2020 ◽  
Vol 27 (7) ◽  
Author(s):  
Mieke Croughs ◽  
Patrick Soentjens
Keyword(s):  
High Risk ◽  
Scoring System ◽  
Evidence Based ◽  
Risk Scoring ◽  
Risk Predictors ◽  
Risk Scoring System ◽  
Rabies Vaccination

We want to introduce a free online scoring system to identify high risk travellers who qualify for pre-travel rabies vaccination. The system uses evidence based risk predictors and the probable availability of HRIG at the destination.

scholarly journals Development of a Sex-Specific Risk Scoring System for Predicting Cognitive Normal to Mild Cognitive Impairment (SRSS-CNMCI)

2021 ◽  
Author(s):  
Wen Luo ◽  
Hao Wen ◽  
Shuqi Ge ◽  
Chunzhi Tang ◽  
Xiufeng Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
High Risk ◽  
Scoring System ◽  
External Validation ◽  
Scoring Systems ◽  
Cutoff Point ◽  
Risk Scoring ◽  
Risk Scoring System

Abstract Objective: We aim to develop a sex-specific risk scoring system for predicting cognitive normal (CN) to mild cognitive impairment (MCI), abbreviated SRSS-CNMCI, to provide a reliable tool for the prevention of MCI.Methods: Participants aged 61-90 years old with a baseline diagnosis of CN and an endpoint diagnosis of MCI were screened from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) database with at least one follow-up. Multivariable Cox proportional hazards models were used to identify risk factors associated with conversion from CN to MCI and to build risk scoring systems for male and female groups. Receiver operating characteristic (ROC) curve analysis was applied to determine the risk probability cutoff point corresponding to the optimal prediction effect. We ran an external validation of the discrimination and calibration based on the Harvard Aging Brain Study (HABS) database.Results: A total of 471 participants, including 240 women (51%) and 231 men (49%), aged 61 to 90 years, were included in the study cohort for subsequent primary analysis. The final multivariable models and the risk scoring systems for females and males included age, APOE ε4, Mini-Mental State Examination (MMSE) and Clinical Dementia Rating (CDR). The scoring systems for females and males revealed C statistics of 0.902 (95% CI 0.840-0.963) and 0.911 (95% CI 0.863-0.959), respectively, as measures of discrimination. The cutoff point of high and low risk was 33% in females, and more than 33% was considered high risk, while more than 9% was considered high risk for males. The external validation effect of the scoring systems was good: C statistic 0.950 for the females and C statistic 0.965 for the males. Conclusions: Our parsimonious model accurately predicts conversion from CN to MCI with four risk factors and can be used as a predictive tool for the prevention of MCI.

scholarly journals The Efficacy of Risk Score System Establishment and Methylprednisolone Stratification Treatment for Pre-Engraftment Syndrome after Unrelated Cord Blood Transplantation: A Retrospective (development) and a Prospective (validation) Study

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 4501-4501
Author(s):  
Xiaoyu Zhu ◽  
Jiang Zhu ◽  
Baolin Tang ◽  
Kaidi Song ◽  
Linlin Jin ◽  
...  
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Risk Score ◽  
Cumulative Incidence ◽  
Scoring System ◽  
Cord Blood Transplantation ◽  
High Risk Factors ◽  
Risk Scoring ◽  
Risk Scoring System ◽  
Different Doses

Introduction Pre-engraftment syndrome (PES) is a common immune reaction prior to neutrophil engraftment after unrelated cord blood transplantation (UCBT), with a unique clinical manifestation of non-infectious fever and skin rash. The reported incidence of PES ranges from 20% to 78%. Although many researchers believe that PES is associated with a high incidence of acute graft-versus-host disease (GVHD) but not with transplant-related mortality (TRM) , relapse, or overall survival (OS), they did not stratify the risk factors of PES, and how to carry out different doses of methylprednisolone (MP) stratified intervention therapy still remains unknown. Method s First, 136 hematological malignancy patients treated with UCBT from April 2000 to February 2012 in our transplantation center were retrospectively analysis. Among them, 92 patients occurred PES. High-risk factors for 180-day TRM in PES patients were established by univariate and multivariate analysis. Then, from January 2013 to August 2016, 221 PES patients were scored according to the risk scoring system and stratified treated with different doses of MP. Finally, in order to validate the efficacy of MP stratification treatment, we conducted a prospective, open label and non-randomized clinical trial including 240 PES patients who underwent UCBT from September 2016 to December 2018. This trial is registered at www.chictr.org.cn as ChiCTR-ONC-16009013. Results The cumulative incidence of neutrophil and platelet engraftment was significantly higher in PES group than non-PES group (97.8% vs 70.5%, P<0.001; 75.0% vs 54.5%, P=0.05). In 92 PES patients, multivariate analysis showed that failed MP treatment, multiple clinical symptoms and early onset of PES were independent high risk factors affecting180-day TRM. One high risk factor was scored as 1. The 92 PES patients were divided into PES-0, PES-1,PES-2 and PES-3, and the higher the score, the higher the TRM (17.7% vs 21.9% vs 62.5% vs 100%,respectively; P<0.001), and the lower the OS (68.3% vs 56.2% vs 25.0% vs 0%, respectively; P<0.001). Then, from January 2013 to August 2016, 221 PES patients were scored as PES-0, PES-1 and PES-2 according to the following two high risk factors (multiple clinical symptoms and early onset of PES) and stratified treated with different doses of MP (0.5mg/kg/d for PES-0, 1mg/kg/d for PES-1 and 2mg/kg/d for PES-2). Compared to the previous PES patients with the same risk score, the 180-day TRM of PES-1 and PES-2 patients was significantly reduced and the OS, disease free survival (DFS), and GVHD-free and Relapse-free survival (GRFS) were significantly increased after stratified treatment. The results in the prospective trial were similar to the retrospective study. In addition, although stratified therapy could significantly improve the prognosis of PES-2 patients cohort, the cumulative incidence of acute GVHD and GRFS are still the worst compared with other risk score patients. Therefore, how to improve the outcomes of PES-2 patients remains to be further studied. Conclusion s PES after UCBT is benefit for engraftment, but should be graded according the risk scoring system. Different doses of MP stratified intervention therapy can significantly improve the prognosis of severe PES patients. The risk scoring system of PES after UCBT and MP stratification treatment are worthy of clinical application. But the cumulative incidence of acute GVHD and GRFS in severe PES patients still need to be ameliorated in the further study. Disclosures No relevant conflicts of interest to declare.

A Risk Scoring System to Identify Emergency Department Patients With Heart Failure at High Risk for Serious Adverse Events

2013 ◽  
Vol 20 (1) ◽  
pp. 17-26 ◽  
Author(s):  
Ian G. Stiell ◽  
Catherine M. Clement ◽  
Robert J. Brison ◽  
Brian H. Rowe ◽  
Bjug Borgundvaag ◽  
...  
Keyword(s):  
Heart Failure ◽  
Emergency Department ◽  
High Risk ◽  
Adverse Events ◽  
Scoring System ◽  
Serious Adverse Events ◽  
Patients With Heart Failure ◽  
Risk Scoring ◽  
Emergency Department Patients ◽  
Risk Scoring System

scholarly journals A Risk-Scoring System Combined With a Fecal Immunochemical Test Is Effective in Screening High-Risk Subjects for Early Colonoscopy to Detect Advanced Colorectal Neoplasms

2016 ◽  
Vol 150 (3) ◽  
pp. 617-625.e3 ◽  
Author(s):  
Han-Mo Chiu ◽  
Jessica Y.L. Ching ◽  
Kai Chun Wu ◽  
Rungsun Rerknimitr ◽  
Jingnan Li ◽  
...  
Keyword(s):  
High Risk ◽  
Colorectal Neoplasms ◽  
Scoring System ◽  
Fecal Immunochemical Test ◽  
Risk Scoring ◽  
Immunochemical Test ◽  
Risk Scoring System

scholarly journals MicroRNA‐based risk scoring system to identify early‐stage oral squamous cell carcinoma patients at high‐risk for cancer‐specific mortality

Head & Neck ◽  
2020 ◽  
Vol 42 (8) ◽  
pp. 1699-1712 ◽  
Author(s):  
Angela J. Yoon ◽  
Shuang Wang ◽  
David I. Kutler ◽  
Richard D. Carvajal ◽  
Elizabeth Philipone ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
High Risk ◽  
Oral Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Scoring System ◽  
Early Stage ◽  
Specific Mortality ◽  
Risk Scoring ◽  
Cancer Specific Mortality ◽  
Risk Scoring System

575 Determining Risk Factors Associated with Development of Depression Following Burn Injury

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S129-S130
Author(s):  
Olivia Stockly ◽  
Audrey E Wolfe ◽  
Shelley A Wiechman ◽  
Kimberly Roaten ◽  
Colleen M Ryan ◽  
...  
Keyword(s):  
High Risk ◽  
Scoring System ◽  
Burn Injury ◽  
Psychological Treatment ◽  
Depression Symptoms ◽  
Post Injury ◽  
Factors Associated ◽  
Depression Risk ◽  
Risk Scoring ◽  
Risk Scoring System

Abstract Introduction Depression symptoms following burn injury are common, however a tool to risk stratify the likelihood of development of these symptoms does not exist. This study aims to examine the demographic and clinical factors associated with depression symptoms at 12 months post-injury. This data will be used to develop a depression risk scoring system. Methods Data from the Burn Model System National Database (2015–2019) were analyzed. Depression subscale scores of the PROMIS-29 were examined at 12 months and those with scores greater than 60 were considered to have depression symptoms. Demographic and clinical characteristics of the study population were compared between those with and without depression symptoms. Predictors of depression symptoms at 12 months post-injury were determined using multivariate logistic regression. Results The analysis included 298 individuals (52 with and 246 without depression symptoms). Those with depression symptoms at 12 months post-injury were more likely to be female, have had psychological treatment in the year prior to injury, and have sustained a suspected self-inflicted burn injury. Those with depression symptoms were less likely to be married or working at the time of injury compared to those without depression symptoms. No differences in age, burn size, race/ethnicity, etiology of injury, or education level were observed between groups (Table 1). Psychological therapy or counseling in the year prior to injury was the only significant predictor of depression symptoms at 12 months post-injury (p= 0.016). Age and female gender approached significance (p=0.092 and p= 0.086, respectively). Conclusions A history of recent pre-injury psychological treatment was the only significant predictor of depressive symptoms found one-year post-injury. Applicability of Research to Practice This data will be used to create a depression risk scoring system to be used at time of acute care admission to identify burn survivors who are at high risk of developing depression. Identifying those at high risk of depression will facilitate appropriate utilization of resources and potential treatment prophylaxis.

188 Predicting Posttraumatic Hydrocephalus: Derivation and Validation of a Risk Scoring System Based on Clinical Characteristics

Neurosurgery ◽  
2017 ◽  
Vol 64 (CN_suppl_1) ◽  
pp. 250-250
Author(s):  
Hao Chen
Keyword(s):  
High Risk ◽  
Scoring System ◽  
Clinical Characteristics ◽  
Injury Severity ◽  
Characteristic Curve ◽  
Derivation Cohort ◽  
Radiologic Findings ◽  
Fisher Grade ◽  
Risk Scoring ◽  
Risk Scoring System

Abstract INTRODUCTION Posttraumatic hydrocephalus (PTH) is a common complication of traumatic brain injury (TBI) and often has a high risk of clinical deterioration and worse outcomes. The incidence and risk factors for the development of PTH after decompressive craniectomy (DC) has been assessed in previous studies, but rare studies identify patients with higher risk for PTH among all TBI patients. This study aimed to develop and validate a risk scoring system to predict PTH after TBI. METHODS Demographics, injury severity, duration of coma, radiologic findings, and DC were evaluated to determine the independent predictors of PTH during hospitalization until 6 months following TBI through logistic regression analysis. A risk stratification system was created by assigning a number of points for each predictor and validated both internally and externally. The model accuracy was assessed by the area under the receiver operating characteristic curve (AUC). RESULTS >Of 526 patients in the derivation cohort, 57 (10.84%) developed PTH during 6 months follow up. Age >50 (Odd ratio [OR] = 1.91, 95% confidence interval [CI] 1.09 3.75, 4 points), duration of coma = 1 w (OR = 5.68, 95% CI 2.57 13.47, 9 points), Fisher grade III (OR = 2.19, 95% CI 1.24 4.36, 5 points) or IV (OR = 3.87, 95% CI 1.93 8.43, 7 points), bilateral DC (OR = 6.13, 95% CI 2.82 18.14, 9 points), and extra herniation after DC (OR = 2.36, 95% CI 1.46 4.92, 5 points) were independently associated with PTH. Rates of PTH for the low- (0-12 points), intermediate- (13-22 points) and high-risk (23-34 points) groups were 1.16%, 35.19% and 78.57% (P < 0.0001). The corresponding rates in the validation cohort, where 17/175 (9.71%) developed PTH, were 1.35%, 37.50% and 81.82% (P < 0.0001). The risk score model exhibited good-excellent discrimination in both cohorts, with AUC of 0.839 versus 0.894 (derivation versus validation) and good calibration (Hosmer-Lemshow P = 0.56 versus 0.68). CONCLUSION A risk scoring system based on clinical characteristics accurately predicted PTH. This model will be useful to identify patients at high risk for PTH who may be candidates for preventive interventions, and to improve their outcomes.

scholarly journals Antipartum surveillance by scoring system for pregnancy outcome of cesarean section in a tertiary referral centre of Madhya Pradesh, India

2018 ◽  
Vol 7 (9) ◽  
pp. 3558
Author(s):  
Sapna B. Jain ◽  
Rashmi Tripathi
Keyword(s):  
High Risk ◽  
Maternal Mortality ◽  
Scoring System ◽  
Maternal Morbidity ◽  
Referral Centre ◽  
Tertiary Referral ◽  
Tertiary Referral Centre ◽  
Risk Pregnancy ◽  
Risk Scoring ◽  
Risk Scoring System

Background: It is imperative to find out high risk pregnancy for providing apt care to the needy mother and fetus, so application of risk scoring system helps in pin pointing the at-risk patient and also gives a notion about the prognosis of fetal and maternal wellbeing. This study aims to evaluate the clinical application of risk scoring system in cesarean delivery for identification and management of risk pregnancies appropriately to improve perinatal and maternal morbidity and mortality.Methods: LNMC Bhopal M.P. a tertiary referral centre with approximately 2100 delivery / year and cesarean rate of 33%, serving primarily rural population. This prospective analytical study conducted from July 2017 till June 2018. Focused on the combination of the principal predictors of obstetric outcome taken from the previously published scoring system were applied on 120 cases of unplanned at risk caesarean section and summed up to identify risk-pregnancy and its predictive value for maternal and perinatal outcome.Results: It was determined by birth weight, APGAR score, birth asphyxia and NICU admission, Perinatal and maternal morbidity and mortality. Out of 120 caesarean cases 25% grouped in high risk, 58.3% low risk and 16.6%moderate group and their perinatal outcome was compared. 90% and 15% of the high risk and moderate group respectively had high risk neonates. In the high-risk group 2% had neonatal death, while no mortality in low risk cases. Maternal outcome was analysed by HDU admission 3% mothers were admitted in HDU with eclampsia and multi organ failure with one maternal mortality due to HELLP syndrome other recovered well, while one patient left against medical advice due to high expenses.Conclusions: Risk evaluation by simplified scoring system is an easy and economical way to identify high risk pregnancy to provide quick, comprehensive and quality health services to needy mother and neonate at right time, thus help in lowering the perinatal and maternal mortality and morbidity even at PHC level.

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