K K Yasar1, F Pehlivanoglu, G Sengoz. 1. Department of Infectious Diseases and Clinical Microbiology, Haseki Training and Research Hospital, Istanbul, Turkey. kadriyeyasar@hasekihastanesi.gov.tr
Abstract
OBJECTIVE: To evaluate predictors of mortality in 160 patients with tuberculous meningitis (TBM). DESIGN: One hundred and sixty patients with TBM who had been followed for 11 years in a tertiary referral centre hospital were assessed retrospectively. Features considered as predictors of mortality in TBM were studied by multivariate logistic regression to develop a prognostic rule. RESULTS: Of 160 patients, 84% were in Stages II and III; 27 (17%) died. In univariate analysis, age, stage, altered sensorium, underlying comorbidities, pulmonary tuberculosis, leukocytosis and cerebrospinal fluid (CSF)/blood glucose < 0.30 and rise in CSF protein were associated with an increased risk of death. In multivariable analysis, age (OR 4.64, 95%CI 1.03-24.74, P = 0.046), altered sensorium (OR 8.62, 95%CI 1.25-110.0, P = 0.036), underlying comorbidity (OR 9.75, 95%CI 1.58-59.95, P = 0.014) and leukocytosis (OR 9.74, 95%CI 1.67-56.7, P = 0.011) were shown to be the best predictors of mortality in TBM. CONCLUSIONS: We observed that TBM patients who died were more likely to be older and have altered mental status on admission, underlying comorbidities and leukocytosis than TBM patients who survived. These factors were the most important predictors of mortality from TBM.
OBJECTIVE: To evaluate predictors of mortality in 160 patients with tuberculous meningitis (TBM). DESIGN: One hundred and sixty patients with TBM who had been followed for 11 years in a tertiary referral centre hospital were assessed retrospectively. Features considered as predictors of mortality in TBM were studied by multivariate logistic regression to develop a prognostic rule. RESULTS: Of 160 patients, 84% were in Stages II and III; 27 (17%) died. In univariate analysis, age, stage, altered sensorium, underlying comorbidities, pulmonary tuberculosis, leukocytosis and cerebrospinal fluid (CSF)/blood glucose < 0.30 and rise in CSF protein were associated with an increased risk of death. In multivariable analysis, age (OR 4.64, 95%CI 1.03-24.74, P = 0.046), altered sensorium (OR 8.62, 95%CI 1.25-110.0, P = 0.036), underlying comorbidity (OR 9.75, 95%CI 1.58-59.95, P = 0.014) and leukocytosis (OR 9.74, 95%CI 1.67-56.7, P = 0.011) were shown to be the best predictors of mortality in TBM. CONCLUSIONS: We observed that TBM patients who died were more likely to be older and have altered mental status on admission, underlying comorbidities and leukocytosis than TBM patients who survived. These factors were the most important predictors of mortality from TBM.
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