A Clinical Prognostic Scoring System for Neurocysticercosis


Por: Marquez-Romero J.M., Huerta-Franco M.R., Soto-Cabrera E., Espinoza-López D.A., Orrego H., Martínez-Jurado E., Zermeño-Pöhls F., Guerrero-Juárez V.

Publicada: 1 ene 2021
Resumen:
Abstract Objectives In patients with neurocysticercosis (NCC), an accurate risk prediction would allow a better therapeutic approach; however, there are currently no tools that can enhance the accuracy of risk prediction. We designed a prognostic scoring system to be used by neurologists and other physicians managing patients with NCC. Materials and Methods Using data from clinical records of patients from a third-level national reference center for neurological diseases, we assessed demographic, clinical, and tomographic variables among 293 patients diagnosed with NCC. Multivariable logistic regression analyses were used to develop a clinical prognostic scoring instrument. Patients with NCC were assessed for neurological impairment at 3 months after diagnosis. Statistical Analysis Score accuracy was assessed by receiver operating characteristic (ROC) curve analysis. The primary outcome was the presence of neurological impairment, resulting in disability according to self-report or caregiver reports; this outcome was assessed during follow-up visits at 3 ± 1 months after discharge. Results The most common symptoms at presentation were headache (67%) and seizure (63%). A six-item (total score from -4 to + 2) prognostic instrument was constructed on the basis of the presence of seizures/headache at presentation, a leukocyte count above 12x 109/dL, the presence of six to ten parasites, subarachnoid localization, and the use of anthelmintic drugs. Among 113 patients with negative scores, 79.6% developed neurological deficits. Among patients with scores of 1 to 2, 64.6% recovered completely, with an overall accuracy of prediction of 74.7% and area under the ROC curve = 0.722 (95% CI, 0.664-0.780, p < 0.0001). Conclusions The clinical prognostic scoring system for NCC described in this study is a new instrument for use in daily clinical practice. It is simple to administer, and it has a prognostic accuracy of 75%. Its use has the potential to improve the quality of care by guiding appropriate decision-making and early management of patients with NCC. © 2021 Georg Thieme Verlag. All rights reserved.

Filiaciones:
Marquez-Romero J.M.:
 Department of Neurology, Instituto Mexicano Del Seguro Social (IMSS) HGZ 2, Av. de Los Conos 102, Ojocaliente, Aguascalientes, 20190, Mexico

Huerta-Franco M.R.:
 Departamento de Ciencias Aplicadas Al Trabajo, Universidad de Guanajuato, Guanajuato, Mexico

Soto-Cabrera E.:
 Department of Neurology, Instituto Nacional de Neurología y Neurocirugía MVS, Mexico City, Mexico

Espinoza-López D.A.:
 Department of Neurology, Instituto Nacional de Neurología y Neurocirugía MVS, Mexico City, Mexico

Orrego H.:
 Department of Neurology, Instituto Nacional de Neurología y Neurocirugía MVS, Mexico City, Mexico

Martínez-Jurado E.:
 Department of Neurology, Instituto Nacional de Neurología y Neurocirugía MVS, Mexico City, Mexico

Zermeño-Pöhls F.:
 Department of Neurology, Instituto Nacional de Neurología y Neurocirugía MVS, Mexico City, Mexico

Guerrero-Juárez V.:
 Department of Neurology, Instituto Nacional de Neurología y Neurocirugía MVS, Mexico City, Mexico
ISSN: 09763147
Editorial
MEDKNOW PUBLICATIONS & MEDIA PVT LTD, B-9, KANARA BUSINESS CENTRE, OFF LINK RD, GHAKTOPAR-E, MUMBAI, 400075, INDIA, India
Tipo de documento: Article
Volumen: 12 Número: 1
Páginas: 39-45
WOS Id: 000606480800004
ID de PubMed: 33531758
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