A self-rated health score predicts severe disease and high mortality in patients with pulmonary TB

Abstract

BACKGROUND: Health-related quality of life (HRQoL) in patients with pulmonary TB may be predictive of disease outcome; however, HRQoL instruments are often complicated and unsuitable for use in low-resource settings. A single-item self-rated health (SRH) score may represent a simpler alternative which could be used in clinical decision-making.AIMS: To evaluate internal and external validity of SRH and its correlation with TBscore/TBscoreII in a low-resource setting.METHODS: We used data from our ongoing prospective TB cohort study in Guinea-Bissau. Cohen´s d was used to assess internal validity, and receiver-operating characteristics and mortality statistics to assess external validity. Correlation between SRH and TBscore/TBscoreII was estimated using linear regression.RESULTS: SRH showed satisfactory internal validity and ability to discriminate between fatal cases at high and low scores, although not at middling scores. SRH and TBscore/TBscoreII correlated well at each examination but changes in scores did not, which may be due to ceiling/floor effects and a lag between disease severity and HRQoL.CONCLUSION: SRH shows potential as a quick and simple method to identify patients in need of intensified follow-up during treatment provision. More research is needed to assess its generalisability beyond our setting and to develop models for clinical use of SRH.

circRNA_SLC8A1 promotes the survival of mycobacterium tuberculosis in macrophages by upregulating expression of autophagy-related protein SQSTM1/p62 to activate the NF-κB pathway

“…The modified Bandim TBscore was used to evaluate the severity in patients with PTB at the time of diagnosis, before the initiation of anti-Tuberculosis treatment 21 , 22 . It considers five symptoms (cough, hemoptysis, dyspnea, chest pain, and night sweats) and seven clinical findings (anemia, pulse > 90 beats/min, positive finding at lung auscultation, temperature > 37 °C (axillary), body mass index (BMI) < 18 and < 16, hypoproteinemia, and bilateral lung involvement in CT or X-ray).…”

Effects of smoking on the severity and transmission of pulmonary tuberculosis: A hospital-based case control study

“…The Bandim TBscore is an easily implemented self-rated instrument for evaluating severity in patients with PTB ( 10 ). It assesses five symptoms (cough, hemoptysis, dyspnea, chest pain, and night sweats) and six signs [pale inferior conjunctivae, pulse >90 per minute, positive findings at lung auscultation, temperature >37°C (axillary), body mass index (BMI) <18/ <16, and mid-upper-arm circumference (MUAC) <220 mm/ <200 mm].…”

“…were defined following a previous study (9) such that heavy smoking was 20 or more cigarettes per day, or more than 20 pack-years, and light smoking was <20 cigarettes per day, or <20 pack-years. The Bandim TBscore is an easily implemented self-rated instrument for evaluating severity in patients with PTB (10). It assesses five symptoms (cough, hemoptysis, dyspnea, chest pain, and night sweats) and six signs [pale inferior conjunctivae, pulse >90 per minute, positive findings at lung auscultation, temperature >37 • C (axillary), body mass index (BMI) <18/<16, and mid-upperarm circumference (MUAC) <220 mm/<200 mm].…”