Hamsi scoring in the prediction of unfavorable outcomes from tuberculous meningitis: results of Haydarpasa-II study
Date
2015Author
Yemisen, Mücahit
ERDEM, Hakan
Karabay, Oguz
SENBAYRAK, Seniha
AGALAR, Canan
VAHABOGLU, Haluk
ONCUL, Oral
SENGOZ, Gonul
OZTURK-ENGIN, Derya
TIRELI, Hulya
KILICOGLU, Gamze
Defres, Sylviane
GULSUN, Serda
CRISAN, Alexandru
JOHANSEN, Isik Somuncu
INAN, Asuman
NECHIFOR, Mihai
AL-MAHDAWI, Akram
CIVLJAK, Rok
Ozguler, Muge
SAVIC, Branislava
CERAN, Nurgul
CACOPARDO, Bruno
Inal, Ayse Seza
Namiduru, Mustafa
Dayan, Saim
Kayabas, Uner
Parlak, Emine
KHALIFA, Ahmad
Kursun, Ebru
Sipahi, Oguz Resat
Akbulut, Ayhan
Bitirgen, Mehmet
POPOVIC, Natasa
Kandemir, Bahar
LUCA, Catalina
Parlak, Mehmet
STAHL, Jean Paul
Pehlivanoğlu, Filiz
SIMEON, Soline
Ulu-Kilic, Aysegul
YASAR, Kadriye
Yilmaz, Gulden
Yilmaz, Emel
BEOVIC, Bojana
CATROUX, Melanie
LAKATOS, Botond
Sunbul, Mustafa
Alabay, Selma
Sahin-Horasan, Elif
KOSE, Sukran
SHEHATA, Ghaydaa
ANDRE, Katell
DRAGOVAC, Gorana
GUL, Hanefi Cem
KARAKAS, Ahmet
CHADAPAUD, Stephane
HANSMANN, Yves
HARXHI, Arjan
KIROVA, Valerija
MASSE-CHABREDIER, Isabelle
Oncu, Serkan
Sener, Alper
Tekin, Recep
Elaldi, Nazif
Deveci, Ozcan
OZKAYA, Hacer Deniz
Metadata
Show full item recordAbstract
Predicting unfavorable outcome is of paramount importance in clinical decision making. Accordingly, we designed this multinational study, which provided the largest case series of tuberculous meningitis (TBM). 43 centers from 14 countries (Albania, Croatia, Denmark, Egypt, France, Hungary, Iraq, Italy, Macedonia, Romania, Serbia, Slovenia, Syria, Turkey) submitted data of microbiologically confirmed TBM patients hospitalized between 2000 and 2012. Unfavorable outcome was defined as survival with significant sequela or death. In developing our index, binary logistic regression models were constructed via 200 replicates of database by bootstrap resampling methodology. The final model was built according to the selection frequencies of variables. The severity scale included variables with arbitrary scores proportional to predictive powers of terms in the final model. The final model was internally validated by bootstrap resampling. A total of 507 patients' data were submitted among which 165 had unfavorable outcome. Eighty-six patients died while 119 had different neurological sequelae in 79 (16 %) patients. The full model included 13 variables. Age, nausea, vomiting, altered consciousness, hydrocephalus, vasculitis, immunosuppression, diabetes mellitus and neurological deficit remained in the final model. Scores 1-3 were assigned to the variables in the severity scale, which included scores of 1-6. The distribution of mortality for the scores 1-6 was 3.4, 8.2, 20.6, 31, 30 and 40.1 %, respectively. Altered consciousness, diabetes mellitus, immunosuppression, neurological deficits, hydrocephalus, and vasculitis predicted the unfavorable outcome in the scoring and the cumulative score provided a linear estimation of prognosis.
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