| Author | Andrade, Hugo Boechat | |
| Author | Silva, Ivan Rocha Ferreira da | |
| Author | Sim, Justin Lee | |
| Author | Mello-Neto, José Henrique | |
| Author | Theodoro, Pedro Henrique Nascimento | |
| Author | Silva, Mayara Secco Torres da | |
| Author | Varela, Margareth Catoia | |
| Author | Ramos, Grazielle Viana | |
| Author | Silva, Aline Ramos da | |
| Author | Bozza, Fernando A. | |
| Author | Soares, Jesus | |
| Author | Belay, Ermias D. | |
| Author | Sejvar, James J. | |
| Author | Cerbino-Neto, José | |
| Author | Japiassú, André Miguel | |
| Access date | 2021-12-27T22:21:05Z | |
| Available date | 2021-12-27T22:21:05Z | |
| Document date | 2021 | |
| Citation | ANDRADE, Hugo Boechat et al. Central nervous system infection in the intensive care unit: Development and validation of a multi-parameter diagnostic prediction tool to identify suspected patients. PloS one, v. 16, n. 11, p. 1-14, 2021 | pt_BR |
| ISSN | 1932-6203 | pt_BR |
| URI | https://www.arca.fiocruz.br/handle/icict/50527 | |
| Language | eng | pt_BR |
| Publisher | Public Library of Science | pt_BR |
| Rights | open access | pt_BR |
| Title | Central nervous system infection in the intensive care unit: Development and validation of a multi-parameter diagnostic prediction tool to identify suspected patients | pt_BR |
| Type | Article | pt_BR |
| DOI | 10.1371/journal.pone.0260551 | |
| xmlui.metadata.dc.description.abstractes | Background: Central nervous system infections (CNSI) are diseases with high morbidity and mortality, and their diagnosis in the intensive care environment can be challenging. Objective: To develop and validate a diagnostic model to quickly screen intensive care patients with suspected CNSI using readily available clinical data.
Methods: Derivation cohort: 783 patients admitted to an infectious diseases intensive care unit (ICU) in Oswaldo Cruz Foundation, Rio de Janeiro RJ, Brazil, for any reason, between 01/01/2012 and 06/30/2019, with a prevalence of 97 (12.4%) CNSI cases. Validation cohort 1: 163 patients prospectively collected, between 07/01/2019 and 07/01/2020, from the same ICU, with 15 (9.2%) CNSI cases. Validation cohort 2: 7,270 patients with 88 CNSI (1.21%) admitted to a neuro ICU in Chicago, IL, USA between 01/01/2014 and 06/30/2019. Prediction model: Multivariate logistic regression analysis was performed to construct the model, and Receiver Operating Characteristic (ROC) curve analysis was used for model validation. Eight predictors-age <56 years old, cerebrospinal fluid white blood cell count >2 cells/mm3, fever (≥38°C/100.4°F), focal neurologic deficit, Glasgow Coma Scale <14 points, AIDS/HIV, and seizure-were included in the development diagnostic model (P<0.05).
Results: The pool data's model had an Area Under the Receiver Operating Characteristics (AUC) curve of 0.892 (95% confidence interval 0.864-0.921, P<0.0001).
Conclusions: A promising and straightforward screening tool for central nervous system infections, with few and readily available clinical variables, was developed and had good accuracy, with internal and external validity. | pt_BR |
| Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Unidade de Tratamento Intensivo. Rio de Janeiro, RJ, Brasil / Universidade Federal Fluminense. Instituto Biomédico. Setor de Doenças Sexualmente Transmissíveis. Niterói, RJ, Brasil. | pt_BR |
| Affilliation | Rush University Medical Center. Department of Neurological Sciences. Chicago, IL, United States of America. | pt_BR |
| Affilliation | Rush University Medical Center. Department of Neurological Sciences. Chicago, IL, United States of America. | pt_BR |
| Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Unidade de Tratamento Intensivo. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Unidade de Tratamento Intensivo. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Unidade de Tratamento Intensivo. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa de Imunização e Vigilância Sanitária. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Affilliation | Instituto D'Or de Pesquisa e Educação. Departamento de Cuidados Críticos. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Affilliation | Instituto D'Or de Pesquisa e Educação. Departamento de Cuidados Críticos. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Unidade de Tratamento Intensivo. Rio de Janeiro, RJ, Brasil / Instituto D'Or de Pesquisa e Educação. Departamento de Cuidados Críticos. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Affilliation | Centers for Disease Control and Prevention. National Center for Emerging and Zoonotic Infectious Diseases. Division of High-Consequence Pathology and Pathogens. Atlanta, GA, United States of America. | pt_BR |
| Affilliation | Centers for Disease Control and Prevention. National Center for Emerging and Zoonotic Infectious Diseases. Division of High-Consequence Pathology and Pathogens. Atlanta, GA, United States of America. | pt_BR |
| Affilliation | Centers for Disease Control and Prevention. National Center for Emerging and Zoonotic Infectious Diseases. Division of High-Consequence Pathology and Pathogens. Atlanta, GA, United States of America. | pt_BR |
| Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa de Imunização e Vigilância Sanitária. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Unidade de Tratamento Intensivo. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Subject | Central nervous system infections | pt_BR |
| Subject | Intensive care unit | pt_BR |
| Subject | Medical risk factors | pt_BR |
| Subject | Cerebrospinal fluid | pt_BR |
| Subject | Encephalitis | pt_BR |
| Subject | Fevers | pt_BR |
