COMPARISON OF GLASGOW COMA SCALE AND MEDICAL RESEARCH COUNCIL SCORES AS PREDICTORS OF INHOSPITAL MORTALITY IN TUBERCULOUS MENINGITIS

Objective: To compare Glasgow Coma Scale and Medical Research Council staging systems as predictors of mortality
in tuberculous meninigits patients.
Study Design: Cross-sectional comparative study.
Methodology: This study was done in departments of Medicine in Hayatabad Medical Complex, Khyber Teaching
Hospital and Lady Reading Hospital in Peshawar from 1st October, 2013 to 31st March, 2014. Hundred (100) patients
with TBM meeting the inclusion and exclusion criteria were assessed in hospital and followed for six months using
MRC and GCS scoring systems.
Results: A total of 100 patients were enrolled in this study. Male patients outnumebered female. Sixty-seven patients
were male and 37 were female. On admission, 22 patients had MRC stage I, 44 had stage II and 34 stage III. The
mean GCS was 2.1. Overall, 28 patients had GCS above 12, 31 had between 9 to 12 and 41 had below 9. Discharge
outcome was graded according to the Glasgow Outcome Scale (GOS). Five patients died during hospital stay, 3
showed MRC stage III and 2 with severe GCS. Total 23 had persistent vegetative state, 16 with MRC III and 18 with
severe GCS. Among 28 severe disable, 22 had MRC stage II while 15 had GCS between 9 to 12. Out of 35, all 22 with
MRC I showed good recovery as compared to 28 patients with mild GCS. The difference in the mean scores of GCS
and MRC systems is .o1 (t value=0.13)
Conclusion: Our study demonstrates that the GCS system is as effective as MRC in predicting the discharge outcome
in patients with tuberculous meningitis.
Keywords: Tuberculous Meningitis, Medical Research Council staging system, Glasgow Coma Scale, Outcome