Derivation and Validation of a Mortality Risk Score for Severe Hand, Foot and Mouth Disease in China
Abstract Outbreaks of hand, foot and mouth disease (HFMD) have increased recently, as has the case fatality rate in severe cases. No scoring system currently exists to predict mortality risk for severe HFMD in previous study. We retrospectively collected laboratory parameters for 546 patients with s...
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2017-06-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-017-02658-4 |
| _version_ | 1818684944588734464 |
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| author | Jun Qiu Xiulan Lu Xiao Liu Ping Zang Wenjiao Zhao Pingping Liu Zhenghui Xiao |
| author_facet | Jun Qiu Xiulan Lu Xiao Liu Ping Zang Wenjiao Zhao Pingping Liu Zhenghui Xiao |
| author_sort | Jun Qiu |
| collection | DOAJ |
| description | Abstract Outbreaks of hand, foot and mouth disease (HFMD) have increased recently, as has the case fatality rate in severe cases. No scoring system currently exists to predict mortality risk for severe HFMD in previous study. We retrospectively collected laboratory parameters for 546 patients with severe HFMD (a derivation and a validation cohort) at Hunan Children’s Hospitals between January 2012 and December 2014. We developed a mortality risk score comprising four laboratory parameters: blood glucose (GLU), white blood cells (WBC), lactate (LAC), and N-terminal-probrain natriuretic peptide (NT-proBNP). Using an “optimal” cutoff score of 4, the sensitivity, specificity, positive predictive value and negative predictive value was 88.00%, 96.14%, 62.86% and 99.08%, respectively, in the derivation cohort. Among severe HFMD patients with low- and high-risk scores in the validation cohort, case fatality rates were 1.49% and 74.07%, respectively. According to the “optimal” cut-off in the derivation cohort, the sensitivity, specificity, positive predictive value, and negative predictive value were 80.95%, 93.83%, 62.96% and 97.44%, respectively, in the derivation cohort. The mortality risk score demonstrated good discrimination (AUC > 0.9) and calibration (P > 0.05) in both cohorts. The mortality risk score, comprising WBC, GLU, LAC and NT-proBNP, has been demonstrated good discrimination and calibration in the both cohorts. |
| first_indexed | 2024-12-17T10:58:41Z |
| format | Article |
| id | doaj.art-5ad1c5521189462bbd3dfae1db6961bb |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-12-17T10:58:41Z |
| publishDate | 2017-06-01 |
| publisher | Nature Portfolio |
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| series | Scientific Reports |
| spelling | doaj.art-5ad1c5521189462bbd3dfae1db6961bb2022-12-21T21:51:45ZengNature PortfolioScientific Reports2045-23222017-06-01711910.1038/s41598-017-02658-4Derivation and Validation of a Mortality Risk Score for Severe Hand, Foot and Mouth Disease in ChinaJun Qiu0Xiulan Lu1Xiao Liu2Ping Zang3Wenjiao Zhao4Pingping Liu5Zhenghui Xiao6Emergency Center, Hunan Children’s HospitalEmergency Center, Hunan Children’s HospitalEmergency Center, Hunan Children’s HospitalEmergency Center, Hunan Children’s HospitalEmergency Center, Hunan Children’s HospitalEmergency Center, Hunan Children’s HospitalEmergency Center, Hunan Children’s HospitalAbstract Outbreaks of hand, foot and mouth disease (HFMD) have increased recently, as has the case fatality rate in severe cases. No scoring system currently exists to predict mortality risk for severe HFMD in previous study. We retrospectively collected laboratory parameters for 546 patients with severe HFMD (a derivation and a validation cohort) at Hunan Children’s Hospitals between January 2012 and December 2014. We developed a mortality risk score comprising four laboratory parameters: blood glucose (GLU), white blood cells (WBC), lactate (LAC), and N-terminal-probrain natriuretic peptide (NT-proBNP). Using an “optimal” cutoff score of 4, the sensitivity, specificity, positive predictive value and negative predictive value was 88.00%, 96.14%, 62.86% and 99.08%, respectively, in the derivation cohort. Among severe HFMD patients with low- and high-risk scores in the validation cohort, case fatality rates were 1.49% and 74.07%, respectively. According to the “optimal” cut-off in the derivation cohort, the sensitivity, specificity, positive predictive value, and negative predictive value were 80.95%, 93.83%, 62.96% and 97.44%, respectively, in the derivation cohort. The mortality risk score demonstrated good discrimination (AUC > 0.9) and calibration (P > 0.05) in both cohorts. The mortality risk score, comprising WBC, GLU, LAC and NT-proBNP, has been demonstrated good discrimination and calibration in the both cohorts.https://doi.org/10.1038/s41598-017-02658-4 |
| spellingShingle | Jun Qiu Xiulan Lu Xiao Liu Ping Zang Wenjiao Zhao Pingping Liu Zhenghui Xiao Derivation and Validation of a Mortality Risk Score for Severe Hand, Foot and Mouth Disease in China Scientific Reports |
| title | Derivation and Validation of a Mortality Risk Score for Severe Hand, Foot and Mouth Disease in China |
| title_full | Derivation and Validation of a Mortality Risk Score for Severe Hand, Foot and Mouth Disease in China |
| title_fullStr | Derivation and Validation of a Mortality Risk Score for Severe Hand, Foot and Mouth Disease in China |
| title_full_unstemmed | Derivation and Validation of a Mortality Risk Score for Severe Hand, Foot and Mouth Disease in China |
| title_short | Derivation and Validation of a Mortality Risk Score for Severe Hand, Foot and Mouth Disease in China |
| title_sort | derivation and validation of a mortality risk score for severe hand foot and mouth disease in china |
| url | https://doi.org/10.1038/s41598-017-02658-4 |
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