ArticlePloS one2022
Performance of the Universal Vital Assessment (UVA) mortality risk score in hospitalized adults with infection in Rwanda: A retrospective external validation study.
Article in PloS one, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 4 of them syntheses that pooled it.
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Who cites it
10 citing papers in PubMed, 4 syntheses or guidelines pooled it, 9 citations in OpenAlex.
- Applications of the Early Warning Score as an outcome measure: a systematic review of methodologies.BMJ health & care informatics · 2026Pooled it
- Accuracy of prognostic scoring tools for ICU triage and mortality among patients in low- and middle-income countries: a systematic review and meta-analysis.BMJ open respiratory research · 2026Pooled it
- Prognostic models for predicting intensive care unit admission or mortality in critically ill adults not yet been admitted to the intensive care unit.The Cochrane database of systematic reviews · 2026Pooled it
- Sepsis screening tools in resource-limited settings: a systematic review and meta-analysis of diagnostic accuracy in low- and middle-income countries.Frontiers in public health · 2026Pooled it
- Effectiveness of early warning scores in predicting in-hospital mortality and adverse events in adult general-ward patients in low- and middle-income countries: A systematic review.African journal of emergency medicine : Revue africaine de la medecine d'urgence · 2026Article
- A narrative review of the pathophysiology of sepsis in sub-Saharan Africa: Exploring the potential for corticosteroid therapy.PLOS global public health · 2025Review
- Factors Associated With Death at 30 Days and Evaluation of Clinical Risk Scores Among Patients With Cancer Admitted With Postchemotherapy Infection in Uganda: A Prospective Cohort Study.Open forum infectious diseases · 2024Article
- Outcomes of adults hospitalized with COVID-19 at the University Teaching Hospital of Butare in Rwanda and validation of the Universal Vital Assessment (UVA) mortality risk score.PLOS global public health · 2024Article
- The Universal Vital Assessment (UVA) score at 6 hours post-resuscitation predicts mortality in hospitalized adults with severe sepsis in Mbarara, Uganda.PLOS global public health · 2024Article
- Inability-to-walk-unaided-a single WHO danger sign predicts in-hospital mortality in people with HIV under routine care conditions in a low-resource setting.Therapeutic advances in infectious diseaseArticle
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Authors and funding
8 authors at 6 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWe previously derived a Universal Vital Assessment (UVA) score to better risk-stratify hospitalized patients in sub-Saharan Africa, including those with infection. Here, we aimed to externally validate the performance of the UVA score using previously collected data from patients hospitalized with acute infection in Rwanda.
methodsWe performed a secondary analysis of data collected from adults ≥18 years with acute infection admitted to Gitwe District Hospital in Rwanda from 2016 until 2017. We calculated the UVA score from the time of admission and at 72 hours after admission. We also calculated quick sepsis-related organ failure assessment (qSOFA) and modified early warning scores (MEWS). We calculated amalgamated qSOFA scores by inserting UVA cut-offs into the qSOFA score, and modified UVA scores by removing the HIV criterion. The performance of each score determined by the area under the receiver operator characteristic curve (AUC) was the primary outcome measure.
resultsWe included 573 hospitalized adult patients with acute infection of whom 40 (7%) died in-hospital. The admission AUCs (95% confidence interval [CI]) for the prediction of mortality by the scores were: UVA, 0.77 (0.68-0.85); modified UVA, 0.77 (0.68-0.85); qSOFA, 0.66 (0.56-0.75), amalgamated qSOFA, 0.71 (0.61-0.80); and MEWS, 0.74 (0.64, 0.83). The positive predictive values (95% CI) of the scores at commonly used cut-offs were: UVA >4, 0.35 (0.15-0.59); modified UVA >4, 0.35 (0.15-0.59); qSOFA >1, 0.14 (0.07-0.24); amalgamated qSOFA >1, 0.44 (0.20-0.70); and MEWS >5, 0.14 (0.08-0.22). The 72 hour (N = 236) AUC (95% CI) for the prediction of mortality by UVA was 0.59 (0.43-0.74). The Chi-Square test for linear trend did not identify an association between mortality and delta UVA score at 72 hours (p = 0.82).
conclusionsThe admission UVA score and amalgamated qSOFA score had good predictive ability for mortality in adult patients admitted to hospital with acute infection in Rwanda. The UVA score could be used to assist with triage decisions and clinical interventions, for baseline risk stratification in clinical studies, and in a clinical definition of sepsis in Africa.
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