Validating a novel index (SWAT-Bp) to predict mortality risk of community-acquired pneumonia in Malawi.

Buss, Imogen M and Innes, Michael A and Birkhamshaw, Edmund and Magadoro, Itai and Waitt, Peter I and Rylance, Jamie (2018) Validating a novel index (SWAT-Bp) to predict mortality risk of community-acquired pneumonia in Malawi. Malawi medical journal : the journal of Medical Association of Malawi, 30 (4). pp. 230-235. ISSN 1995-7270. This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs

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Official URL: http://www.mmj.mw/?p=8687

Abstract

Background

Community-acquired pneumonia is a major cause of mortality worldwide. Early assessment and initiation of management improves outcomes. In higher-income countries, scores assist in predicting mortality from pneumonia. These have not been validated for use in most lower-income countries.

Aim

To validate a new score, the SWAT-Bp score, in predicting mortality risk of clinical community-acquired pneumonia amongst hospital admissions at Queen Elizabeth Central Hospital, Blantyre, Malawi.

Methods

The five variables constituting the SWAT-Bp score (male [S]ex, muscle [W]asting, non-[A]mbulatory, [T]emperature (>38°C or <35°C) and [B]lood [p]ressure (systolic<100 and/or diastolic<60)) were recorded for all patients with clinical presentation of a lower respiratory tract infection, presumed to be pneumonia, over four months (N=216). The sensitivity and specificity of the score were calculated to determine accuracy of predicting mortality risk.

Results

Median age was 35 years, HIV prevalence was 84.2% amongst known statuses, and mortality rate was 12.5%. Mortality for scores 0-5 was 0%, 8.5%, 12.7%, 19.0%, 28.6%, 100% respectively. Patients were stratified into three mortality risk groups dependent on their score. SWAT-Bp had moderate discriminatory power overall (AUROC 0.744). A SWAT-Bp score of ≥2 was 82% sensitive and 51% specific for predicting mortality, thereby assisting in identifying individuals with a lower mortality risk.

Conclusion

In this validation cohort, the SWAT-Bp score has not performed as well as in the derivation cohort. However, it could potentially assist clinicians identifying low-risk patients, enabling rapid prioritisation of treatment in a low-resource setting, as it helps contribute towards individual patient risk stratification.

Item Type: Article
Additional Information: This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs
Subjects: WC Communicabable diseases
WF Respiratory system. Respiratory medicine
Divisions: Clinical Support > Infectious Diseases
Related URLs:
Depositing User: Mrs Suganthi Vijayaganesh
Date Deposited: 18 Dec 2019 16:12
Last Modified: 18 Dec 2019 16:12
URI: http://www.repository.uhblibrary.co.uk/id/eprint/2695

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