Unsuccessful validation of a model for prediction of academic or behavioral limitations after childhood bacterial meningitis

Aim: Previously a model identifying children at risk of academic or behavioral limitations after bacterial meningitis (BM) was developed. Risk factors were: male gender, birth weight <3000 grams, lower educational level of the father, Streptococcus pneumoniae, lower cerebrospinal fluid (CSF) leukocyte count, delay >6 hours between admission and start of antibiotics, dexa-methasone <2 days, seizures treated with anticonvulsive drugs, prolonged fever >9 days. Aim was to validate this prediction model in an independent cohort. Academic or behavioral limitations were determined in 93 Dutch school-age BM survivors. Risk factors for limitations were obtained from medical files. Validation was performed by application of the model in the cohort followed by assessment of discrimination (Area Under the Curve (AUC) of the Receiver Operated Characteristics (ROC) curve) and goodness of fit (Hosmer-Lemeshow test). Multiple imputation techniques were used to deal with missing values.