title: Prognostic accuracy of five simple scales in childhood bacterial meningitis.
abstract: BACKGROUND
  In childhood acute bacterial meningitis, the level of consciousness, measured with the Glasgow coma scale (GCS) or the Blantyre coma scale (BCS), is the most important predictor of outcome. The Herson-Todd scale (HTS) was developed for Haemophilus influenzae meningitis. Our objective was to identify prognostic factors, to form a simple scale, and to compare the predictive accuracy of these scales.
  
  
  METHODS
  Seven hundred and twenty-three children with bacterial meningitis in Luanda were scored by GCS, BCS, and HTS. The simple Luanda scale (SLS), based on our entire database, comprised domestic electricity, days of illness, convulsions, consciousness, and dyspnoea at presentation. The Bayesian Luanda scale (BLS) added blood glucose concentration. The accuracy of the 5 scales was determined for 491 children without an underlying condition, against the outcomes of death, severe neurological sequelae or death, or a poor outcome (severe neurological sequelae, death, or deafness), at hospital discharge.
  
  
  RESULTS
  The highest accuracy was achieved with the BLS, whose area under the curve (AUC) for death was 0.83, for severe neurological sequelae or death was 0.84, and for poor outcome was 0.82. Overall, the AUCs for SLS were ≥0.79, for GCS were ≥0.76, for BCS were ≥0.74, and for HTS were ≥0.68.
  
  
  CONCLUSIONS
  Adding laboratory parameters to a simple scoring system, such as the SLS, improves the prognostic accuracy only little in bacterial meningitis.
authors.affiliation: Hospital Pediátrico David Bernardino, Luanda, Angola. tuula.i.pelkonen@hus.fi
authors.forename: Tuula
authors.initials: T
authors.lastname: Pelkonen
authors.forename: Irmeli
authors.initials: I
authors.lastname: Roine
authors.forename: Lurdes
authors.initials: L
authors.lastname: Monteiro
authors.forename: Manuel Leite
authors.initials: ML
authors.lastname: Cruzeiro
authors.forename: Anne
authors.initials: A
authors.lastname: Pitkäranta
authors.forename: Matti
authors.initials: M
authors.lastname: Kataja
authors.forename: Heikki
authors.initials: H
authors.lastname: Peltola
mesh_terms: D000810:Angola; D002675:Child, Preschool; D016208:Databases, Factual; D003906:Developing Countries; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D016920:Meningitis, Bacterial / Q000175:diagnosis* / Q000503:physiopathology; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011379:Prognosis; D012372:ROC Curve; D012307:Risk Factors; D012720:Severity of Illness Index; D016896:Treatment Outcome