scholarly journals Novel clinical risk scoring model for predicting mortality in patients with necrotizing fasciitis

Medicine ◽  
2021 ◽  
Vol 100 (51) ◽  
pp. e28219
Author(s):  
Patcharin Khamnuan ◽  
Nipaporn Chuayunan ◽  
Acharaporn Duangjai ◽  
Surasak Saokaew ◽  
Natthaya Chaomuang ◽  
...  
Keyword(s):  
Necrotizing Fasciitis ◽  
Scoring Model ◽  
Clinical Risk ◽  
Risk Scoring

scholarly journals Novel Clinical Risk Scoring Model for Predicting Amputation in Patients With Necrotizing Fasciitis: The ANF Risk Scoring System

2021 ◽  
Vol 8 ◽  
Author(s):  
Natthaya Chaomuang ◽  
Patcharin Khamnuan ◽  
Nipaporn Chuayunan ◽  
Acharaporn Duangjai ◽  
Surasak Saokaew ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Necrotizing Fasciitis ◽  
Risk Score ◽  
Scoring System ◽  
Characteristic Curve ◽  
Positive Likelihood Ratio ◽  
Clinical Predictors ◽  
Clinical Risk ◽  
Risk Scoring ◽  
Risk Scoring System

Background: Necrotizing fasciitis (NF) is a life-threatening infection of the skin and soft tissue that spreads quickly and requires immediate surgery and medical treatment. Amputation or radical debridement of necrotic tissue is generally always required. The risks and benefits of both the surgical options are weighed before deciding whether to amputate or debride. This study set forth to create an easy-to-use risk scoring system for predicting the risk scoring system for amputation in patients with NF (ANF).Methods: This retrospective study included 1,506 patients diagnosed with surgically confirmed NF at three general hospitals in Thailand from January 2009 to December 2012. All diagnoses were made by surgeons who strictly observed the guidelines for skin and soft tissue infections produced by the Infectious Diseases Society of America. Patients were randomly allocated to either the derivation (n = 1,193) or validation (n = 313) cohort. Clinical risk factors assessed at the time of recruitment were used to create the risk score, which was then developed using logistic regression. The regression coefficients were converted into item scores, and the total score was calculated.Results: The following four clinical predictors were used to create the model: female gender, diabetes mellitus, wound appearance stage 3 (skin necrosis and gangrene), and creatinine ≥1.6 mg/dL. Using the area under the receiver operating characteristic curve (AuROC), the ANF system showed moderate power (78.68%) to predict amputation in patients with NF with excellent calibration (Hosmer-Lemeshow χ2 = 2.59; p = 0.8586). The positive likelihood ratio of amputation in low-risk (score ≤ 4) and high-risk (score ≥ 7) patients was 2.17 (95%CI: 1.66–2.82) and 6.18 (95%CI: 4.08–9.36), respectively. The ANF system showed good performance (AuROC 76.82%) when applied in the validation cohort.Conclusion: The developed ANF risk scoring system, which includes four easy to obtain predictors, provides physicians with prediction indices for amputation in patients with NF. This model will assist clinicians with surgical decision-making in this time-sensitive clinical setting.

scholarly journals Validation of a clinical risk-scoring algorithm for severe scrub typhus

2014 ◽  
pp. 29
Author(s):  
Sirianong Namwongprom ◽  
Pamornsri Sriwongpan ◽  
Jayanton Patumanond ◽  
Pornsuda Krittigamas ◽  
Hutsaya Tantipong ◽  
...  
Keyword(s):  
Scrub Typhus ◽  
Clinical Risk ◽  
Scoring Algorithm ◽  
Risk Scoring

Assessment of Risk Scoring Model for Prediction of Endometrial Cancer Among Symptomatic Postmenopausal Women (A Prospective Cohort Study)

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Magdy M Abd Elgawaad ◽  
Amr M El Helaly ◽  
Malames M Faisal ◽  
Asmaa F Kasem
Keyword(s):  
Endometrial Cancer ◽  
Family History ◽  
Endometrial Carcinoma ◽  
Endometrial Hyperplasia ◽  
Endometrial Thickness ◽  
Serous Carcinoma ◽  
Scoring Model ◽  
Gynecological Malignancy ◽  
Risk Scoring ◽  
Study Population

Abstract Background Endometrial carcinoma is the most common gynecological malignancy in the developed countries and the third common gynecological malignancy in Egypt after breast and ovarian cancers. Aim of the Work to evaluate this risk scoring model on Egyptian patients and to study the effect of adding other patient characteristics (DM, BMI and relevant family history) on the sensitivity and specificity of RHEA scoring model. Patients and Methods The current study was conducted in Ain Shams University Maternity Hospital in the period between September 2017 and December 2018. A total of 100 women with postmenopausal bleeding and endometrial thickness > 4mm were included in the study. Results Histological examination revealed that benign pathology (n = 65) (73%) was found to be: most common cause was endometrial hyperplasia without atypia (20.3%) followed by chronic endometritis (13.5%), then endometrial polyp (11.3%), cystic atrophy of endometrium (8.9%), proliferative endometrium (8.9%), endometrial hyperplasia with atypia (6.7%) and lastly mucous polyp (3.4%) while malignant histopathology(n = 24)(27%) which is significantly higher than the international rates showed: Endometriod adenocarcinoma (n = 19)(21.3%), papillary serous carcinoma (n = 4)(4.5%) and undifferentiated carcinoma (n = 1)(1.1%). The current study showed that RHEA score performs in our study population with a comparable validity to that reported by its inventors with sensitivity 79.2% (57.8% - 92.9%) vs. 87.5% and specificity 84.6% (73.5% - 92.4%) vs. 80.1% respectively. In results of the current study it was found that the time since onset of menopause rather than age was associated with endometrial cancer with the optimum cut-off for postmenopausal duration was estimated to be 9 years achieving a sensitivity of 87.5% and a specificity of 60.0%, but it needs multivariate analysis on larger and more representative sample size to confirm this association, A statistically significant regression model was including only postmenopausal duration, recurrent bleeding and endometrial thickness. None of age, BMI, family history or hypertension proved a statistically significant predictive effect after adjustment for other predictive variables. Conclusion Taking in consideration the higher prevalence of endometrial carcinoma in the sample of the current study, the wide 95% confidence intervals for the different validity indices for the RHEA scores derived from this study, it seems that RHEA score performs in this study population with a comparable validity to that reported by its inventors.

A risk-scoring model for the prediction of delayed bleeding after colorectal endoscopic submucosal dissection

2019 ◽  
Vol 89 (5) ◽  
pp. 990-998.e2 ◽  
Author(s):  
Myeongsook Seo ◽  
Eun Mi Song ◽  
Jin Woong Cho ◽  
Young Jae Lee ◽  
Bo-In Lee ◽  
...  
Keyword(s):  
Endoscopic Submucosal Dissection ◽  
Scoring Model ◽  
Delayed Bleeding ◽  
Submucosal Dissection ◽  
Risk Scoring ◽  
Colorectal Endoscopic Submucosal Dissection

scholarly journals FP314A RISK SCORING MODEL TO PREDICT RENAL PROGRESSION IN CHRONIC KIDNEY DISEASE PATIENTS WITH CONTRAST INDUCED NEPHROPATHY

2018 ◽  
Vol 33 (suppl_1) ◽  
pp. i137-i137
Author(s):  
Seung Don Baek ◽  
Mun Jang ◽  
Wonhak Kim ◽  
Eun Kyoung Lee ◽  
So Mi Kim ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Contrast Induced Nephropathy ◽  
Scoring Model ◽  
Risk Scoring ◽  
Renal Progression

scholarly journals Development of a risk scoring system for prognostication in HIV-related toxoplasma encephalitis

2020 ◽  
Author(s):  
Yao Li ◽  
Yanming Zeng ◽  
Min Liu ◽  
Yanqiu Lu ◽  
Xueyan Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Scoring System ◽  
Risk Model ◽  
Therapeutic Interventions ◽  
Scoring Model ◽  
Cell Counts ◽  
Toxoplasma Encephalitis ◽  
Specific Risk ◽  
Risk Scoring ◽  
Risk Scoring System

Abstract Objective: This study aims to evaluate specific risk factors influencing prognosis of HIV-infected patients with toxoplasma encephalitis (TE) in order to develop a prognostic risk scoring system for them. Methods: This is a six-center retrospective study of hospitalized HIV/TE patients. Data including six-week mortality after diagnosis, baseline characteristics, clinical features, laboratory tests and radiological characteristics of eligible patients were assimilated for risk model establishing.Results: In this study, the six-week mortality among 94 retrospective cases was 11.7% (11/94). Seven specific risk factors, viz. time from symptom onset to presentation, fever, dizziness, CD4+ T-cell counts, memory deficits, patchy brain lesions, and disorders of consciousness were calculated to be statistically associated with mortality. A criterion value of ‘9’ was selected as the optimal cut-off value of the established model. The AUC of the ROC curve of this scoring model was 0.976 (p<0.001). The sensitivity and specificity of the risk scoring model was 100.0% and 86.9%, respectively, which were 81.8% and 94.1% of this scoring model in the verification cohort, respectively. Conclusions: The developed scoring system was established with simple risk factors, which also allows expeditious implementation of accurate prognostication, and appropriate therapeutic interventions in HIV-infected patients with TE.

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