title: Validation of a Dutch risk score predicting poor outcome in adults with bacterial meningitis in Vietnam and Malawi.
abstract: We have previously developed and validated a prognostic model to predict the risk for unfavorable outcome in Dutch adults with bacterial meningitis. The aim of the current study was to validate this model in adults with bacterial meningitis from two developing countries, Vietnam and Malawi. Demographic and clinical characteristics of Vietnamese (n = 426), Malawian patients (n = 465) differed substantially from those of Dutch patients (n = 696). The Dutch model underestimated the risk of poor outcome in both Malawi and Vietnam. The discrimination of the original model (c-statistic [c] 0.84; 95% confidence interval 0.81 to 0.86) fell considerably when re-estimated in the Vietnam cohort (c = 0.70) or in the Malawian cohort (c = 0.68). Our validation study shows that new prognostic models have to be developed for these countries in a sufficiently large series of unselected patients.
authors.affiliation: Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Ewout S
authors.initials: ES
authors.lastname: Schut
authors.forename: Matthijs C
authors.initials: MC
authors.lastname: Brouwer
authors.forename: Matthew
authors.initials: M
authors.lastname: Scarborough
authors.forename: Nguyen Thi Hoang
authors.initials: NT
authors.lastname: Mai
authors.forename: Guy E
authors.initials: GE
authors.lastname: Thwaites
authors.forename: Jeremy J
authors.initials: JJ
authors.lastname: Farrar
authors.forename: Johannes B
authors.initials: JB
authors.lastname: Reitsma
authors.forename: Diederik
authors.initials: D
authors.lastname: van de Beek
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005260:Female; D005840:Gentian Violet; D015600:Glasgow Coma Scale; D006339:Heart Rate; D006801:Humans; D007958:Leukocyte Count; D008295:Malawi; D008297:Male; D016920:Meningitis, Bacterial / Q000175:diagnosis*; D008875:Middle Aged; D008954:Models, Biological; D009426:Netherlands; D010619:Phenazines; D011237:Predictive Value of Tests; D011379:Prognosis; D012372:ROC Curve; D012307:Risk Factors; D014744:Vietnam; D055815:Young Adult
chemical_list: C035863:Gram's stain; D010619:Phenazines; D005840:Gentian Violet