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
-
Published:2022-04
Issue:4
Volume:7
Page:e008143
-
ISSN:2059-7908
-
Container-title:BMJ Global Health
-
language:en
-
Short-container-title:BMJ Glob Health
Author:
Rees Chris A, Colbourn TimORCID, Hooli Shubhada, King Carina, Lufesi Norman, McCollum Eric DORCID, Mwansambo Charles, Cutland Clare, Madhi Shabir AhmedORCID, Nunes Marta, Mathew Joseph L, Addo-Yobo Emmanuel, Chisaka Noel, Hassan Mumtaz, Hibberd Patricia L, Jeena Prakash M, Lozano Juan M, MacLeod William B, Patel Archana, Thea Donald M, Nguyen Ngoc Tuong Vy, Kartasasmita Cissy B, Lucero Marilla, Awasthi Shally, Bavdekar Ashish, Chou Monidarin, Nymadawa Pagbajabyn, Pape Jean-William, Paranhos-Baccala Glaucia, Picot Valentina S, Rakoto-Andrianarivelo Mala, Rouzier Vanessa, Russomando Graciela, Sylla Mariam, Vanhems Philippe, Wang Jianwei, Asghar Rai, Banajeh Salem, Iqbal Imran, Maulen-Radovan Irene, Mino-Leon Greta, Saha Samir K, Santosham Mathuram, Singhi Sunit, Basnet Sudha, Strand Tor A, Bhatnagar Shinjini, Wadhwa Nitya, Lodha Rakesh, Aneja Satinder, Clara Alexey W, Campbell Harry, Nair Harish, Falconer Jennifer, Qazi Shamim A, Nisar Yasir B, Neuman Mark I
Abstract
IntroductionExisting 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.MethodsWe 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.ResultsA 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).ConclusionsThe 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.
Funder
Bill & Melinda Gates Foundation
Subject
Public Health, Environmental and Occupational Health,Health Policy
Cited by
13 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献
|
|