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Derivation and validation of a novel risk assessment tool to identify children aged 2-59 months at risk of hospitalised pneumonia-related mortality in 20 countries.

Authors :
Rees CA
Colbourn T
Hooli S
King C
Lufesi N
McCollum ED
Mwansambo C
Cutland C
Madhi SA
Nunes M
Matthew JL
Addo-Yobo E
Chisaka N
Hassan M
Hibberd PL
Jeena PM
Lozano JM
MacLeod WB
Patel A
Thea DM
Nguyen NTV
Kartasasmita CB
Lucero M
Awasthi S
Bavdekar A
Chou M
Nymadawa P
Pape JW
Paranhos-Baccala G
Picot VS
Rakoto-Andrianarivelo M
Rouzier V
Russomando G
Sylla M
Vanhems P
Wang J
Asghar R
Banajeh S
Iqbal I
Maulen-Radovan I
Mino-Leon G
Saha SK
Santosham M
Singhi S
Basnet S
Strand TA
Bhatnagar S
Wadhwa N
Lodha R
Aneja S
Clara AW
Campbell H
Nair H
Falconer J
Qazi SA
Nisar YB
Neuman MI
Source :
BMJ global health [BMJ Glob Health] 2022 Apr; Vol. 7 (4).
Publication Year :
2022

Abstract

Introduction: Existing risk assessment tools to identify children at risk of hospitalised pneumonia-related mortality have shown suboptimal discriminatory value during external validation. Our objective was to derive and validate a novel risk assessment tool to identify children aged 2-59 months at risk of hospitalised pneumonia-related mortality across various settings.<br />Methods: We used primary, baseline, patient-level data from 11 studies, including children evaluated for pneumonia in 20 low-income and middle-income countries. Patients with complete data were included in a logistic regression model to assess the association of candidate variables with the outcome hospitalised pneumonia-related mortality. Adjusted log coefficients were calculated for each candidate variable and assigned weighted points to derive the Pneumonia Research Partnership to Assess WHO Recommendations (PREPARE) risk assessment tool. We used bootstrapped selection with 200 repetitions to internally validate the PREPARE risk assessment tool.<br />Results: A total of 27 388 children were included in the analysis (mean age 14.0 months, pneumonia-related case fatality ratio 3.1%). The PREPARE risk assessment tool included patient age, sex, weight-for-age z-score, body temperature, respiratory rate, unconsciousness or decreased level of consciousness, convulsions, cyanosis and hypoxaemia at baseline. The PREPARE risk assessment tool had good discriminatory value when internally validated (area under the curve 0.83, 95% CI 0.81 to 0.84).<br />Conclusions: The PREPARE risk assessment tool had good discriminatory ability for identifying children at risk of hospitalised pneumonia-related mortality in a large, geographically diverse dataset. After external validation, this tool may be implemented in various settings to identify children at risk of hospitalised pneumonia-related mortality.<br />Competing Interests: Competing interests: None declared.<br /> (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Details

Language :
English
ISSN :
2059-7908
Volume :
7
Issue :
4
Database :
MEDLINE
Journal :
BMJ global health
Publication Type :
Academic Journal
Accession number :
35428680
Full Text :
https://doi.org/10.1136/bmjgh-2021-008143