The Lambarene Organ Dysfunction Score (LODS) Is a Simple Clinical Predictor of Fatal Malaria in African Children
The Lambarene Organ Dysfunction Score (LODS) Is a Simple Clinical Predictor of Fatal Malaria in African Children
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DOI：
10.1086/648409
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发表时间：
2009-12-15
影响因子：
6.4
通讯作者：
Kremsner, Peter Gottfried
中科院分区：
文献类型：
--
作者：
Helbok, Raimund;Kendjo, Eric;Kremsner, Peter Gottfried
背景恶性疟原虫疟疾每年造成100多万人死亡，其中大多数是撒哈拉以南非洲的幼儿。识别那些可能死亡的人至关重要。有几个因素与死亡独立相关。由于疟疾是一种全身性疾病，结合这些风险因素的定量评分可能更优越。我们使用向前和向后逐步逻辑回归来选择死亡的最佳预测因素，并对23，890名患有严重恶性疟原虫疟疾的非洲儿童进行了评估。研究于2000年12月至2005年5月在6个医院为基础的研究单位（冈比亚的班珠尔、马拉维的布兰太尔、肯尼亚的基利菲、加纳的库马西和加蓬的兰巴内和利伯维尔）进行，该研究属于一个研究非洲儿童严重疟疾的网络（即SMAC网络）。兰巴内器官功能障碍评分（LODS）包括3个变量：昏迷、虚脱和深呼吸。LODS >0（比值比，9.6; 95%置信区间，8.0-11.4）预测死亡的灵敏度为85%，LODS> 0（比值比，9.6; 95%置信区间，8.0-11.4）预测死亡的灵敏度为85%，LODS> 0（比值比，9.6; 95%置信区间，8.0 -11.4）预测死亡的灵敏度为85%。
Background. Plasmodium falciparum malaria accounts for >1 million deaths annually, mostly among young children in sub-Saharan Africa. Identifying those individuals who are likely to die is crucial. Several factors have been independently associated with death. Because malaria is a systemic disease, a quantitative score combining such risk factors may be superior.Methods. We used both forward and backward stepwise logistic regression to select the best predictors of death, as evaluated for 23,890 African children with severe P. falciparum malaria. The study was conducted from December 2000 through May 2005 in 6 hospital-based research units (in Banjul in the Gambia, Blantyre in Malawi, Kilifi in Kenya, Kumasi in Ghana, and Lambarene and Libreville in Gabon) in a network established to study severe malaria in African children (ie, the SMAC Network).Results. The Lambarene Organ Dysfunction Score (LODS) combines 3 variables: coma, prostration, and deep breathing. A LODS >0 (odd ratio, 9.6; 95% confidence interval, 8.0-11.4) has 85% sensitivity to predict death, and a LODS