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dc.contributor.authorHanson, Joshen_US
dc.contributor.authorLee, Sue J.en_US
dc.contributor.authorMohanty, Sanjiben_US
dc.contributor.authorFaiz, M. Abulen_US
dc.contributor.authorAnstey, Nicholas M.en_US
dc.contributor.authorPrice, Ric N.en_US
dc.contributor.authorPrakaykaew Charunwatthanaen_US
dc.contributor.authorประกายแก้ว จรูญวรรธนะen_US
dc.contributor.authorYunus, Emran Binen_US
dc.contributor.authorMishra, Saroj K.en_US
dc.contributor.authorTjitra, Emilianaen_US
dc.contributor.authorRidwanur Rahmanen_US
dc.contributor.authorFrancois Nostenen_US
dc.contributor.authorHtut, Yeen_US
dc.contributor.authorMaude, Richard J.en_US
dc.contributor.authorChau, Tran Thi Hongen_US
dc.contributor.authorPhu, Nguyen Hoanen_US
dc.contributor.authorHien, Tran Tinhen_US
dc.contributor.authorWhite, Nicholas J.en_US
dc.contributor.authorDay, Nicholas P. J.en_US
dc.contributor.authorDondorp, Arjen M.en_US
dc.contributor.otherMahidol University. Faculty of Tropical Medicine. Mahidol Oxford Tropical Medicine Research Unit.en_US
dc.identifier.citationHanson J, Lee SJ, Mohanty S, Faiz MA, Anstey NM, Price RN, et al. Rapid clinical assessment to facilitate the triage of adults with falciparum malaria, a retrospective analysis. PLoS One. 2014 Jan 29;9(1):e87020.en_US
dc.identifier.issn1932-6203 (electronic)-
dc.description.abstractBACKGROUND: Most adults dying from falciparum malaria will die within 48 hours of their hospitalisation. An essential component of early supportive care is the rapid identification of patients at greatest risk. In resource-poor settings, where most patients with falciparum malaria are managed, decisions regarding patient care must frequently be made using clinical evaluation alone. METHODS: We retrospectively analysed 4 studies of 1801 adults with severe falciparum malaria to determine whether the presence of simple clinical findings might assist patient triage. RESULTS: If present on admission, shock, oligo-anuria, hypo- or hyperglycaemia, an increased respiratory rate, a decreased Glasgow Coma Score and an absence of fever were independently predictive of death. The variables were used to construct a simple clinical algorithm. When applied to the 1801 patients, this algorithm's positive predictive value for survival to 48 hours was 99.4 (95% confidence interval (CI) 97.8-99.9) and for survival to discharge 96.9% (95% CI 94.3-98.5). In the 712 patients receiving artesunate, the algorithm's positive predictive value for survival to 48 hours was 100% (95% CI 97.3-100) and to discharge was 98.5% (95% CI 94.8-99.8). CONCLUSIONS: Simple clinical findings are closely linked to the pathophysiology of severe falciparum malaria in adults. A basic algorithm employing these indices can facilitate the triage of patients in settings where intensive care services are limited. Patients classified as low-risk by this algorithm can be safely managed initially on a general ward whilst awaiting senior clinical review and laboratory data.en_US
dc.rightsMahidol Universityen_US
dc.subjectMalaria, falciparumen_US
dc.subjectPatient selection-
dc.subjectOpen Access article-
dc.titleRapid clinical assessment to facilitate the triage of adults with falciparum malaria, a retrospective analysis.en_US
dc.rights.holderPLOS ONEen_US
dc.contributor.correspondenceHanson, Joshen_US
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