title: Hamsi scoring in the prediction of unfavorable outcomes from tuberculous meningitis: results of Haydarpasa-II study.
abstract: 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.
authors: Department of Infectious Diseases and Clinical Microbiology, GATA Haydarpasa Training Hospital, Istanbul, Turkey, hakanerdem1969@yahoo.com.
authors: Hakan
authors: H
authors: Erdem
authors: Derya
authors: D
authors: Ozturk-Engin
authors: Hulya
authors: H
authors: Tireli
authors: Gamze
authors: G
authors: Kilicoglu
authors: Sylviane
authors: S
authors: Defres
authors: Serda
authors: S
authors: Gulsun
authors: Gonul
authors: G
authors: Sengoz
authors: Alexandru
authors: A
authors: Crisan
authors: Isik Somuncu
authors: IS
authors: Johansen
authors: Asuman
authors: A
authors: Inan
authors: Mihai
authors: M
authors: Nechifor
authors: Akram
authors: A
authors: Al-Mahdawi
authors: Rok
authors: R
authors: Civljak
authors: Muge
authors: M
authors: Ozguler
authors: Branislava
authors: B
authors: Savic
authors: Nurgul
authors: N
authors: Ceran
authors: Bruno
authors: B
authors: Cacopardo
authors: Ayse Seza
authors: AS
authors: Inal
authors: Mustafa
authors: M
authors: Namiduru
authors: Saim
authors: S
authors: Dayan
authors: Uner
authors: U
authors: Kayabas
authors: Emine
authors: E
authors: Parlak
authors: Ahmad
authors: A
authors: Khalifa
authors: Ebru
authors: E
authors: Kursun
authors: Oguz Resat
authors: OR
authors: Sipahi
authors: Mucahit
authors: M
authors: Yemisen
authors: Ayhan
authors: A
authors: Akbulut
authors: Mehmet
authors: M
authors: Bitirgen
authors: Natasa
authors: N
authors: Popovic
authors: Bahar
authors: B
authors: Kandemir
authors: Catalina
authors: C
authors: Luca
authors: Mehmet
authors: M
authors: Parlak
authors: Jean Paul
authors: JP
authors: Stahl
authors: Filiz
authors: F
authors: Pehlivanoglu
authors: Soline
authors: S
authors: Simeon
authors: Aysegul
authors: A
authors: Ulu-Kilic
authors: Kadriye
authors: K
authors: Yasar
authors: Gulden
authors: G
authors: Yilmaz
authors: Emel
authors: E
authors: Yilmaz
authors: Bojana
authors: B
authors: Beovic
authors: Melanie
authors: M
authors: Catroux
authors: Botond
authors: B
authors: Lakatos
authors: Mustafa
authors: M
authors: Sunbul
authors: Oral
authors: O
authors: Oncul
authors: Selma
authors: S
authors: Alabay
authors: Elif
authors: E
authors: Sahin-Horasan
authors: Sukran
authors: S
authors: Kose
authors: Ghaydaa
authors: G
authors: Shehata
authors: Katell
authors: K
authors: Andre
authors: Gorana
authors: G
authors: Dragovac
authors: Hanefi Cem
authors: HC
authors: Gul
authors: Ahmet
authors: A
authors: Karakas
authors: Stéphane
authors: S
authors: Chadapaud
authors: Yves
authors: Y
authors: Hansmann
authors: Arjan
authors: A
authors: Harxhi
authors: Valerija
authors: V
authors: Kirova
authors: Isabelle
authors: I
authors: Masse-Chabredier
authors: Serkan
authors: S
authors: Oncu
authors: Alper
authors: A
authors: Sener
authors: Recep
authors: R
authors: Tekin
authors: Nazif
authors: N
authors: Elaldi
authors: Ozcan
authors: O
authors: Deveci
authors: Hacer Deniz
authors: HD
authors: Ozkaya
authors: Oguz
authors: O
authors: Karabay
authors: Seniha
authors: S
authors: Senbayrak
authors: Canan
authors: C
authors: Agalar
authors: Haluk
authors: H
authors: Vahaboglu
mesh_terms: D000328:Adult; D002986:Clinical Trials as Topic; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007391:International Cooperation; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases; D017063:Outcome Assessment, Health Care; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014390:Tuberculosis, Meningeal / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy*
references: Future Microbiol. 2012 Sep;7(9):1101-16
references: 22953709
references: Electroencephalogr Clin Neurophysiol. 1998 Jul;107(1):39-43
references: 9743271
references: Euro Surveill. 2013 Mar 21;18(12):null
references: 23557944
references: Stat Med. 1992 Dec;11(16):2093-109
references: 1293671
references: Tubercle. 1990 Sep;71(3):161-8
references: 2238120
references: J Infect. 2013 Apr;66(4):330-7
references: 23291048
references: Lancet. 1948 Apr 17;1(6503):582-96
references: 18911226
references: J Neurol Neurosurg Psychiatry. 2000 Mar;68(3):300-3
references: 10675210
references: PLoS One. 2011;6(11):e27900
references: 22132165
references: Int J Tuberc Lung Dis. 1999 Mar;3(3):261-5
references: 10094329
references: Indian J Tuberc. 2013 Jan;60(1):5-14
references: 23540083
references: Clin Microbiol Infect. 2014 Oct;20(10):O600-8
references: 24849547
references: J Microbiol Immunol Infect. 2010 Apr;43(2):111-8
references: 20457427
references: J Clin Epidemiol. 2001 Aug;54(8):774-81
references: 11470385
references: Int J Tuberc Lung Dis. 2010 Oct;14(10):1330-5
references: 20843426
references: Stat Med. 2011 Feb 20;30(4):377-99
references: 21225900
references: Int J Tuberc Lung Dis. 2010 Jan;14(1):86-92
references: 20003700
references: Int J Tuberc Lung Dis. 2002 Jan;6(1):64-70
references: 11931403
references: J Neurol Sci. 1996 Apr;137(1):57-61
references: 9120488
references: Clin Neurol Neurosurg. 1999 Sep;101(3):157-60
references: 10536900
references: J Clin Epidemiol. 2004 Feb;57(2):147-53
references: 15125624