Old age and hydrocephalus are associated with poor prognosis in patients with tuberculous meningitis: A retrospective study in a Chinese adult population.
Old age and hydrocephalus are associated with poor prognosis in patients with tuberculous meningitis: A retrospective study in a Chinese adult population.
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DOI：
10.1097/md.0000000000007370
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发表时间：
2017-06
期刊：
影响因子：
1.6
通讯作者：
Pan HY
中科院分区：
文献类型：
--
作者：
Huang HJ;Ren ZZ;Dai YN;Tong YX;Yang DH;Chen MJ;Huang YC;Wang MS;Zhang JJ;Song WY;Pan HY
结核性脑膜炎（TBM）是中枢神经系统结核病的最常见形式，预后极差。我们的目的是评估与 TBM 患者预后相关的危险因素。回顾性纳入2013年1月至2015年12月我院收治的45例TBM住院患者。根据出院时的格拉斯哥结果量表系统来定义患者的良好或不良预后。 GOS 评分低于 5 分的患者被定义为“预后不良”。进行单变量和多变量逻辑回归分析来评估 TBM 结果的预测因素。在 45 名 TBM 患者中，分别有 35 名（77.8%）和 10 名（22.2%）预后不良。高龄、意识障碍、中重度脑电图异常、脑积水、脑脊液蛋白质（≥236mg/dL）和白细胞计数（≥243 /μL）显着升高与预后不良相关。多变量分析表明，高龄（比值比（OR） = 18.395，P = .036）和脑积水（OR = 32.995，P = .049）是TBM预后不良的独立因素。总之，高龄和脑积水是 TBM 预后不良的预测因素。具有这些危险因素的患者应立即接受特别护理治疗，以改善其预后。
Tuberculous meningitis (TBM) is the most common form of central nervous system tuberculosis with a very poor prognosis. We aimed at assessing risk factors related to the prognosis of patients with TBM. Forty-five inpatients with TBM in our institution from January 2013 to December 2015 were enrolled retrospectively. The good or poor prognosis in the patients was defined, based on Glasgow Outcome Scale System at discharge. Patients with a GOS score less than 5 were defined as “poor prognosis.” Univariate and multivariate logistic regression analyses were performed to assess the predictors for TBM outcome. Among 45 TBM patients, 35 (77.8%) and 10 (22.2%) were in good, poor prognoses, respectively. Old age, disturbance of consciousness, moderate to severe electroencephalogram abnormality, hydrocephalus, remarkable increase of protein (≥ 236 mg/dL) and white blood cell counts (≥ 243 /μL) in cerebral spinal fluid were associated with poor prognosis. Multivariate analysis indicated that old age (odds ratio (OR) = 18.395, P = .036) and hydrocephalus (OR = 32.995, P = .049) were independent factors for a poor outcome of TBM. In conclusion, old age and hydrocephalus are the predictors for poor prognosis of TBM. Patients with these risk factors should be treated promptly with a special care paid to improve their outcomes.