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Validation of a clinical risk-scoring algorithm for severe scrub typhus.
[scrub typhus]
The
aim
of
the
study
reported
here
was
to
validate
the
risk-scoring
algorithm
for
prognostication
of
scrub
typhus
severity
.
The
risk-scoring
algorithm
for
prognostication
of
scrub
typhus
severity
developed
earlier
from
two
general
hospitals
in
Thailand
was
validated
using
an
independent
dataset
of
scrub
typhus
patients
in
one
of
the
hospitals
from
a
few
years
later
.
The
predictive
performances
of
the
two
datasets
were
compared
by
analysis
of
the
area
under
the
receiver-operating
characteristic
curve
(
AuROC
)
.
Classification
of
patients
into
non-
severe
,
severe
,
and
fatal
cases
was
also
compared
.
The
proportions
of
non-
severe
,
severe
,
and
fatal
patients
by
operational
definition
were
similar
between
the
development
and
validation
datasets
.
Patient
,
clinical
,
and
laboratory
profiles
were
also
similar
.
Scores
were
similar
in
both
datasets
,
both
in
terms
of
discriminating
non-
severe
from
severe
and
fatal
patients
(
AuROC
=
88
.
74
%
versus
91
.
48
%
,
P
=
0
.
324
)
,
and
in
discriminating
fatal
from
severe
and
non-
severe
patients
(
AuROC
=
88
.
66
%
versus
91
.
22
%
,
P
=
0
.
407
)
.
Over-
and
under-estimations
were
similar
and
were
clinically
acceptable
.
The
previously
developed
risk-scoring
algorithm
for
prognostication
of
scrub
typhus
severity
performed
similarly
with
the
validation
data
and
the
first
dataset
.
The
scoring
algorithm
may
help
in
the
prognostication
of
patients
according
to
their
severity
in
routine
clinical
practice
.
Clinicians
may
use
this
scoring
system
to
help
make
decisions
about
more
intensive
investigations
and
appropriate
treatments
.
Diseases
Validation
Diseases presenting
"routine clinical practice"
symptom
adrenal incidentaloma
congenital adrenal hyperplasia
cystinuria
scrub typhus
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