title: Risk factors predicting complications in blood culture-proven typhoid fever in adults.
abstract: To create a prognostic model for complications of blood culture-proven typhoid fever in adults (> or = 15 y old), a retrospective cohort was assembled though review of the medical records of the hospitalized patients treated for typhoid fever over a 3-y period ending January 1995. Of the 59 patients included, 21 (35.6%) developed various complications of typhoid fever. No patient included died. Four baseline variables (abdominal pain, systolic blood pressure < 100 mmHg, hypoalbuminaemia < 32 g/l and laboratory evidence of disseminated intravascular coagulation) were independently associated with complications and were used to create a prognostic model. The prediction accuracy of the model was determined using the concordance index (c-index). The results (c-index, 0.915 [95%, CI, 89.0-93.0]) showed that the model predicted complications significantly better than chance. The model stratified patients into 3 prognostic stages: low risk for complications (0%; stage I), intermediate risk (42.9%; stage II) and high risk (92.3%; stage III) (p = 0.001). If validated in other settings, it will help clinicians in predicting complications in patients with blood culture-proven typhoid fever on admission.
authors.affiliation: Department of Medical Microbiology, University of Natal Medical School, Durban, South Africa.
authors.forename: M
authors.initials: M
authors.lastname: Khan
authors.forename: Y
authors.initials: Y
authors.lastname: Coovadia
authors.forename: C
authors.initials: C
authors.lastname: Connolly
authors.forename: A W
authors.initials: AW
authors.lastname: Sturm
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D004211:Disseminated Intravascular Coagulation / Q000209:etiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000209:etiology; D008297:Male; D015233:Models, Statistical; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012485:Salmonella typhi; D012709:Serum Albumin / Q000032:analysis; D014435:Typhoid Fever / Q000150:complications* / Q000382:microbiology
chemical_list: D012709:Serum Albumin