Liu et al reported a model for predicting early death for a patient with severe aplastic anemia. This can help to identify a patient who may require more aggressive management. The authors are from Chinese Academy of Medical Sciences and Peking Union Medical College in Tianjin, China
Patient selection: severe aplastic anemia, ages 5 to 70 years
Outcome: death within 3 months of starting immunosuppressive therapy (IST)
Parameters:
(1) age of the patient in years
(2) absolute neutrophil count in 10^9/L
(3) serum ferritin in ng/mL
(4) number of fever times before immunosuppressive therapy (IST), defined as te time of fever onset to the time that the patient's temperature had ballen below 37.5°C for 3 consecutive days without NSAID or steroid therapy
Parameters
Findings
Points
age of patient
<= 24 years
0
> 24 years
3
absolute neutrophil count
<= 0.015 * 10^9/L
4
> 0.015 * 10^9/L
0
serum ferritin
<= 900 ng/mL
0
> 900 ng/mL
3
number of fever times
0 or 1
0
>= 2
2
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 12
Score
Risk Level
Early Death
0 to 4
low
1.2 - 1.3%
5 to 7
medium
8 - 11%
8 to 12
high
39 - 46%
Performance:
• The area under the ROC curve was 0.84 in the training and 0.86 in the validation cohorts.
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