Sumeet R Dhawan1, Anju Gupta1, Pratibha Singhi2, Naveen Sankhyan1, Prahbhjot Malhi1, N Khandelwal3. 1. Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India. 2. Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India doctorpratibhasinghi@gmail.com. 3. Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Abstract
AIMS: To assess the long-term outcome of childhood tuberculous meningitis treated with modern 4-drug antitubercular regimens and to determine predictors of survival and morbidity. METHODS: In this single-center prospective cohort, outcome of children with tuberculous meningitis treated with standard regimens was assessed at 6 months and 12 months after discharge using the Pediatric Cerebral Performance Category Scale. RESULTS: Of 130 children, 38 died in hospital and 34 were either severely disabled or comatose/vegetative at discharge. At 6 and 12 months, 87% of the survivors were either normal (n = 62) or mildly disabled (n = 17, on the Pediatric Cerebral Performance Category scale). On multivariate analysis, the factors associated with poor outcome at 12 months were stage III at admission (adjusted odds ratio 4.4, 95% confidence interval, 1.7-11.2, P = .002) and presence of infarcts on neuroimaging (adjusted odds ratio 2.6, 95% confidence interval, 1.1-6.6, P = .037). CONCLUSIONS: Despite the high in-hospital mortality, in resource-constraint settings, the survivors showed remarkable improvement, with two-thirds returning to a normal functional status at 6 months' follow-up.
AIMS: To assess the long-term outcome of childhood tuberculous meningitis treated with modern 4-drug antitubercular regimens and to determine predictors of survival and morbidity. METHODS: In this single-center prospective cohort, outcome of children with tuberculous meningitis treated with standard regimens was assessed at 6 months and 12 months after discharge using the Pediatric Cerebral Performance Category Scale. RESULTS: Of 130 children, 38 died in hospital and 34 were either severely disabled or comatose/vegetative at discharge. At 6 and 12 months, 87% of the survivors were either normal (n = 62) or mildly disabled (n = 17, on the Pediatric Cerebral Performance Category scale). On multivariate analysis, the factors associated with poor outcome at 12 months were stage III at admission (adjusted odds ratio 4.4, 95% confidence interval, 1.7-11.2, P = .002) and presence of infarcts on neuroimaging (adjusted odds ratio 2.6, 95% confidence interval, 1.1-6.6, P = .037). CONCLUSIONS: Despite the high in-hospital mortality, in resource-constraint settings, the survivors showed remarkable improvement, with two-thirds returning to a normal functional status at 6 months' follow-up.
Authors: María Isabel Sánchez-Códez; Manuel Lubián-Gutiérrez; Carmen Fernández-Bravo; Myriam Ley-Martos Journal: Childs Nerv Syst Date: 2019-06-29 Impact factor: 1.475
Authors: Carol S Palackdkharry; Stephanie Wottrich; Erin Dienes; Mohamad Bydon; Michael P Steinmetz; Vincent C Traynelis Journal: PLoS One Date: 2022-09-30 Impact factor: 3.752