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Value of different staging systems for predicting neurological outcome in childhood tuberculous meningitis

dc.contributor.authorVan Toorn R.
dc.contributor.authorSpringer P.
dc.contributor.authorLaubscher J.A.
dc.contributor.authorSchoeman J.F.
dc.date.accessioned2012-05-17T08:14:42Z
dc.date.available2012-05-17T08:14:42Z
dc.date.issued2012
dc.identifier.citationInternational Journal of Tuberculosis and Lung Disease
dc.identifier.citation16
dc.identifier.citation5
dc.identifier.citation628
dc.identifier.citation632
dc.identifier.issn10273719
dc.identifier.other10.5588/ijtld.11.0648
dc.identifier.urihttp://hdl.handle.net/10019.1/21003
dc.description.abstractBACKGROUND: The stage of tuberculous meningitis (TBM) at presentation is strongly associated with prognosis. OBJECTIVE: To compare different staging systems for TBM in predicting outcome. METHODS: The associations of different staging systems with neurological outcome were assessed using clinical, diagnostic and outcome data of 554 TBM children admitted to Tygerberg Children's Hospital from January 1985 to April 2005. RESULTS: The refined Medical Research Council (MRC) scale after 1 week (84%, 95%CI 81-88) had the highest discriminatory power in predicting neurological morbidity. The Glasgow Coma Score (GCS) on admission, GCS after 1 week, the 'refined' MRC scale on admission and Tygerberg Children's Hospital (TCH) staging method all had excellent discriminatory powers in predicting outcome. Improvement of staging after 1 week occurred in children who did not have signs of raised intracranial pressure (P = 0.004) or brainstem dysfunction on admission (P = 0.030). CONCLUSIONS: The 'refined' MRC scale 1 week after diagnosis showed the best association with neurological outcome after 6 months of treatment. The excellent discriminatory power of the TCH scale and its simplicity of use make it the ideal scale for use in resource-poor settings. © 2012 The Union.
dc.subjectacetazolamide
dc.subjectdiuretic agent
dc.subjectethionamide
dc.subjectfurosemide
dc.subjectisoniazid
dc.subjectprednisone
dc.subjectpyrazinamide
dc.subjectrifampicin
dc.subjectadolescent
dc.subjectanastomosis
dc.subjectarea under the curve
dc.subjectarticle
dc.subjectbrain dysfunction
dc.subjectbrain ventricle peritoneum shunt
dc.subjectcerebrospinal fluid analysis
dc.subjectchild
dc.subjectcommunicating hydrocephalus
dc.subjectcontrolled study
dc.subjectdisease classification
dc.subjectfemale
dc.subjectGlasgow coma scale
dc.subjecthemiparesis
dc.subjecthospital admission
dc.subjecthuman
dc.subjectintracranial pressure
dc.subjectlumbar puncture
dc.subjectmajor clinical study
dc.subjectmale
dc.subjectmorbidity
dc.subjectMycobacterium tuberculosis
dc.subjectneurologic disease
dc.subjectoutcome assessment
dc.subjectpediatric hospital
dc.subjectpleocytosis
dc.subjectprediction
dc.subjectpreschool child
dc.subjectpriority journal
dc.subjectprognosis
dc.subjectprospective study
dc.subjectquadriplegia
dc.subjectschool child
dc.subjectscoring system
dc.subjecttuberculous meningitis
dc.titleValue of different staging systems for predicting neurological outcome in childhood tuberculous meningitis
dc.typeArticle


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