A mathematical approach in the management of hydrocephalus from tuberculous meningitis

• Main Authors: Saranza, Gerard Raimon M., Sumalapao, Derick Erl P., Batara, Julette Marie F., Arceo, Carlene Perpetua P.
• Format: text
• Published: Animo Repository 2017
• Subjects: Hydrocephalus—Surgery—Mathematical models; Meninges—Tuberculosis; Logistic regression analysis; Biology; Medicine and Health Sciences
• Online Access: https://animorepository.dlsu.edu.ph/faculty_research/3471; https://animorepository.dlsu.edu.ph/context/faculty_research/article/4473/type/native/viewcontent/njppp.2017.7.0517402072017
• Institution: De La Salle University

Background: The unavailability of standardized treatment algorithms to properly select tuberculous meningitis (TBM) patients for surgery delays optimal management. Aim and Objective: This study developed a mathematical model as an objective guide in deciding whether to perform surgical intervention or not among patients with hydrocephalus from TBM. Materials and Methods: Using 13 different clinical and cerebrospinal fluid parameters, a saturated logistic regression model was developed and tried retrospectively on 37 previously managed cases of hydrocephalus from TBM. Results: The model is statistically significant (P = 0.0170) with 93.2% concordance index in predicting physician’s decision on admission whether the patient will undergo surgical intervention or not. Patients are recommended for surgical intervention if g-score >0.04 with 90.48% sensitivity. Conclusion: With its significant P-value and high concordance index, the model is a good representative of the actual decision making of physicians in the management of hydrocephalus from TBM. © 2017 Derick Erl P Sumalapao, et al.