TB Research

Derivation of a bedside score (MASH-P) to predict 6-month mortality in tuberculous meningitis

Rizvi I, Malhotra HS, Garg RK, Kumar N

Journal of the neurological sciences · 2020-05

Abstract

Background Tuberculous meningitis is commonly associated with a poor outcome. Simple bedside prognostic scores can help immensely in predicting the outcome. Materials and method A total of 721 patients, from 5 of our previous studies, were included. With primary outcome measure as death, a prognostic model was derived using binary logistic regression. The model was assessed using discrimination and calibration, and internally validated using the bootstrap method. A bedside prognostic score was derived by rounding of the regression coefficients to the nearest integers. Results A total of 126 (17.48%) patients died. The final model found that higher age, stage III disease, baseline MBI ≤ 12, papilledema and hydrocephalus were significant predictors of death. The final model showed good discrimination as evident by an AUC = 83.1% (95% confidence interval 79.5%-86.7%, P Conclusion MASH-P is a simple prognostic scoring model that can be used at bedside and aid in decision making as well as counselling.

MeSH terms

  • Humans
  • Tuberculosis, Meningeal
  • Prognosis
  • Logistic Models
  • Probability