Hoen et al developed a logistic regression model for predicting mortality in a patient with pneumococcal meningitis. This can help to identify a patient who may benefit from more aggressive management. The authors are from CHU de Nancy in France.
Patient selection: pneumococcal (Streptococcus pneumoniae) meningitis, age range 1 to 87 years
Outcome: mortality
Parameters:
(1) Glasgow coma score (from 3 to 15)
(2) age in years
(3) CSF glucose in mmol/L
(4) concomitant pneumonia
Parameter
Finding
Points
Glasgow coma score
>= 7
-2.36
< 7
0
age
<= 45 years
0
> 45 years
1.90
CSF glucose
< 0.6 mmol/L
0
>= 0.6 mmol/L
-1.89
concomittant pneumonia
no
0
yes
1.30
where:
• GCS < 7, age > 45, low CSF glucose and concomitant pneumonia are associated with increased risk of mortality.
X =
= SUM(points for all 4 parameters) - 0.24
probability of mortality =
= 1 / (1 + EXP((-1) * X))
Performance:
• The sensitivity was 39% and specificity 97%.
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