1. Predicting mortality in febrile adults: comparative performance of the MEWS, qSOFA, and UVA scores using prospectively collected data among patients in four health-care sites in sub-Saharan Africa and South-Eastern AsiaResearch in context
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Sham Lal, Manophab Luangraj, Suzanne H. Keddie, Elizabeth A. Ashley, Oliver Baerenbold, Quique Bassat, John Bradley, John A. Crump, Nicholas A. Feasey, Edward W. Green, Kevin C. Kain, Ioana D. Olaru, David G. Lalloo, Chrissy h. Roberts, David C.W. Mabey, Christopher C. Moore, Heidi Hopkins, Sara Ajanovic, Benjamin Amos, Stéphanie Baghoumina, Núria Balanza, Tsitsi Bandason, Tapan Bhattacharyya, Stuart D. Blacksell, Zumilda Boca, Christian Bottomley, Justina M. Bramugy, Clare IR. Chandler, Vilada Chansamouth, Mabvuto Chimenya, Joseph Chipanga, Anelsio Cossa, Ethel Dauya, Catherine Davis, Xavier de Lamballerie, Justin Dixon, Somyoth Douangphachanh, Audrey Dubot-Pérès, Michelle M. Durkin, Rashida A. Ferrand, Colin Fink, Elizabeth JA. Fitchett, Alessandro Gerada, Stephen R. Graves, Edward Green, Becca L. Handley, Coll D. Hutchison, Risara Jaksuwan, Jessica Jervis, Jayne Jones, Khamxeng Khounpaseuth, Katharina Kranzer, Khamfong Kunlaya, Pankaj Lal, Yoel Lubell, David CW. Mabey, Eleanor MacPherson, Forget Makoga, Sengchanh Manichan, Tegwen Marlais, Florian Maurer, Mayfong Mayxay, Michael Miles, Polycarp Mogeni, Campos Mucasse, Paul N. Newton, Chelsea Nguyen, Vilayouth Phimolsarnnousith, Mathieu Picardeau, Chrissy H. Roberts, Amphone Sengduangphachanh, Siho Sengsavang, Molly Sibanda, Somvai Singha, John Stenos, Ampai Tanganuchitcharnchai, Hira Tanvir, James E. Ussher, Marta Valente, Marie A. Voice, Manivanh Vongsouvath, Msopole Wamaka, L Joseph Wheat, and Shunmay Yeung
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Severity scores ,Prognostic scores ,Mortality ,qSOFA ,MEWS ,UVA ,Medicine (General) ,R5-920 - Abstract
Summary: Background: Clinical severity scores can identify patients at risk of severe disease and death, and improve patient management. The modified early warning score (MEWS), the quick Sequential (Sepsis-Related) Organ Failure Assessment (qSOFA), and the Universal Vital Assessment (UVA) were developed as risk-stratification tools, but they have not been fully validated in low-resource settings where fever and infectious diseases are frequent reasons for health care seeking. We assessed the performance of MEWS, qSOFA, and UVA in predicting mortality among febrile patients in the Lao PDR, Malawi, Mozambique, and Zimbabwe. Methods: We prospectively enrolled in- and outpatients aged ≥ 15 years who presented with fever (≥37.5 °C) from June 2018–March 2021. We collected clinical data to calculate each severity score. The primary outcome was mortality 28 days after enrolment. The predictive performance of each score was determined using area under the receiver operating curve (AUC). Findings: A total of 2797 participants were included in this analysis. The median (IQR) age was 32 (24–43) years, 38% were inpatients, and 60% (1684/2797) were female. By the time of follow-up, 7% (185/2797) had died. The AUC (95% CI) for MEWS, qSOFA and UVA were 0.67 (0.63–0.71), 0.68 (0.64–0.72), and 0.82 (0.79–0.85), respectively. The AUC comparison found UVA outperformed both MEWS (p
- Published
- 2024
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