Predictive model for the diagnosis of tuberculous pleural effusion
Braz. j. infect. dis
;
11(1): 83-88, Feb. 2007. graf
Artigo
em Inglês
| LILACS
| ID: lil-454686
ABSTRACT
This study developed a predictive model to identify pleural tuberculosis. A consecutive cases study of patients investigating the cause of pleural effusion, in an area of high prevalence of tuberculosis (Rio de Janeiro, Brazil). Clinical and laboratory variables were compared among patients with tuberculosis (TB) and without tuberculosis (NTB), individually and using logistic regression. The performance was described as diagnostic accuracy, compared to a gold standard in a masked way. We have studied 104 TB patients, 41 with malignant, 29 transudates, 28 parapneumonic, 13 with miscellaneous diseases. After identification of individual discrimination power aided by clinical, radiological and laboratory variables, the following ones were included in a multivariate analysis:
ADA, total leukocytes, percentile of lymphocytes, protein, lactate dehydrogenase, duration of disease, age and gender. A logistic regression model to predict pleural tuberculosis including the five first variables showed the best performance. A receiver operating characteristic curve identified the best cutoff at 0.7, resulting in a sensitivity and specificity of more then 95 percent. The predictive model improved the specificity of ADA alone, keeping its sensitivity. This model seems helpful when a microbiological or histological diagnosis of pleural tuberculosis could not be established. External validation of these results is necessary before recommendation for routine application.
Texto completo:
DisponíveL
Índice:
LILACS (Américas)
Assunto principal:
Derrame Pleural
/
Tuberculose Pleural
/
Adenosina Desaminase
/
Ensaios Enzimáticos Clínicos
/
L-Lactato Desidrogenase
Tipo de estudo:
Estudo diagnóstico
/
Estudos de avaliação
/
Guia de Prática Clínica
/
Estudo prognóstico
Limite:
Feminino
/
Humanos
/
Masculino
Idioma:
Inglês
Revista:
Braz. j. infect. dis
Assunto da revista:
Doenças Transmissíveis
Ano de publicação:
2007
Tipo de documento:
Artigo
País de afiliação:
Brasil
Instituição/País de afiliação:
Federal University of Rio de Janeiro/BR
/
Federal University of the State of Rio de Janeiro/BR
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