New Disease-Severity Score may Predicts Mortality Risk in Pulmonary TB

Pulmonary tuberculosis remains a significant global health concern, necessitating effective tools for predicting and managing mortality risks. Researchers have developed a simple and effective disease-severity score, known as the AHL score, which accurately predicts mortality risk in patients with pulmonary tuberculosis. This innovative scoring system relies on three easily measurable clinical parameters: activity in daily living, hypoxemia, and lymphocyte count.

The AHL score demonstrated remarkable accuracy in stratifying patients into low, intermediate, and high mortality-risk groups, offering a valuable tool for healthcare providers to optimize treatment and improve outcomes for individuals with pulmonary tuberculosis.

This study was published in CHEST. A research team led by Takeshi O. leveraged data from a previous prospective study involving newly diagnosed pulmonary tuberculosis patients. They also prospectively recruited patients between March 2021 and September 2022 to create a validation cohort.

The primary endpoint of the study was all-cause in-hospital mortality. Researchers utilized Cox proportional hazards regression to develop a mortality-risk prediction model based on objective clinical factors. This model led to the creation of the AHL disease-severity score, which assigned integral points to each variate.

• The study analyzed data from 252 patients in the development cohort and 165 patients in the validation cohort.
  
• Among these, 39 patients (15.5%) in the development cohort and 17 patients (10.3%) in the validation cohort unfortunately died during their hospital stay.
• The AHL disease-severity score proved to be a highly effective tool for predicting mortality risk, with a c-statistic of 0.902 in the development cohort and 0.842 in the validation cohort.
• To facilitate ease of use, the score was categorised into three groups: scores 0, 1–2, and 3–4.
• These groups corresponded clearly to low (0 and 1.3%), intermediate (13.5 and 8.9%), and high (55.8 and 39.3%) mortality-risk categories in the development and validation cohorts, respectively.

In summary, this study introduces a simple yet powerful AHL disease-severity score that enables healthcare professionals to accurately assess mortality risk in pulmonary tuberculosis patients. This tool has the potential to enhance patient care and treatment outcomes, ultimately contributing to better management of this challenging respiratory condition.

Reference:

Osawa, T., Watanabe, M., Morimoto, K., Yoshiyama, T., Matsuda, S., Fujiwara, K., Furuuchi, K., Shimoda, M., Ito, M., Kodama, T., Uesugi, F., Okumura, M., Tanaka, Y., Sasaki, Y., Ogata, H., Goto, H., Kudoh, S., & Ohta, K. AHL score for predicting mortality risk in patients with pulmonary tuberculosis. Chest,2023. https://doi.org/10.1016/j.chest.2023.09.008