The Boston AIDS Survival Score (BASS): a multidimensional AIDS severity instrument.
OBJECTIVE
This study developed a new acquired immunodeficiency syndrome (AIDS) severity system by including diagnostic, physiological, functional, and sociodemographic factors predictive of survival.


METHODS
Three-hundred five persons with AIDS in Boston were interviewed; their medical records were reviewed and vital status ascertained.


RESULTS
Overall median (+/- SD) survival for the cohort from the first interview until death was 560 +/- 14.4 days. The best model for predicting survival, the Boston AIDS Survival Score, included the Justice score (stage 2 relative hazard [RH] = 1.25, 95% confidence interval [CI] = 0.80, 1.96; stage 3 RH = 1.76, 95% CI = 1.15, 2.70), a newly developed opportunistic disease score (Boston Opportunistic Disease Survival Score; stage 2 RH = 1.35, 95% CI = 0.90, 2.02; stage 3 RH = 2.10, 95% CI = 1.38, 3.18), and measures of activities of daily living (any intermediate limitations, RH = 1.84, 95% CI = 1.05, 3.21; any basic limitations, RH = 2.60, 95% CI = 1.44, 4.69). This model had substantially greater predictive power (R2 = .17, C statistic = .68) than the Justice score alone (R2 = .09, C statistic = .61).


CONCLUSIONS
Incorporating data on clinically important events and functional status into a physiologically based system can improve the prediction of survival with AIDS.
Seage
G R
GR
Institute for Urban Health Policy and Research, Boston Department of Health and Hospitals, Mass., USA.
Gatsonis
C
C
Weissman
J S
JS
Haas
J S
JS
Cleary
P D
PD
Fowler
F J
FJ
Massagli
M P
MP
Stone
V E
VE
Craven
D E
DE
Makadon
H
H
Goldberg
J
J
Coltin
K
K
Levin
K S
KS
Epstein
A M
AM
D000163:Acquired Immunodeficiency Syndrome / Q000401:mortality*; D000203:Activities of Daily Living; D000328:Adult; D001900:Boston; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008499:Medical Records; D011379:Prognosis; D016016:Proportional Hazards Models; D012720:Severity of Illness Index; D016019:Survival Analysis