Old age and hydrocephalus are associated with poor prognosis in patients with tuberculous meningitis

Huang, Haijun; Ren, Ze-Ze; Dai, Yining; Tong, Yongxi; Yang, Danhong; Chen, Mei-Juan; Huang, Yicheng; Wang, Mingshan; Zhang, Jiajie; Song, Wenyuan; Pan, Hongying

doi:10.1097/md.0000000000007370

Cited by 13 publications

(10 citation statements)

References 26 publications

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“…Besides, Hydrocephalus was significantly associated with poor outcomes; since hydrocephalus is the most common and serious complication of TBM. 18 , 19 This finding is supported by those of other studies. 17 Hence, the results of this study agree with the findings of previous studies.…”

Section: Discussionsupporting

confidence: 89%

Tuberculous Meningitis in Children: Treatment Outcomes at Discharge and Its Associated Factors in Eastern Ethiopia: A Five Years Retrospective Study

Abdella¹,

Deginet²,

Weldegebreal³

et al. 2022

IDR

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Background Tuberculous meningitis is a serious public health problem, particularly in low-income countries. It is associated with high rates of mortality and morbidity. The outcome of tuberculous meningitis in children is not well documented in Ethiopia, particularly in eastern Ethiopia. This study aimed to determine the treatment outcomes of tuberculous meningitis at discharge and its associated factors in eastern Ethiopia. Methods An institutional-based retrospective cross-sectional study was conducted on 121 children who were admitted and treated for tuberculous meningitis between January 2017 and December 2021. Data were collected using a pretested checklist, coded and entered into EpiData version 3.1, and analyzed using Statistical Package for the Social Sciences (SPSS) version 25. Factors associated with treatment outcomes were identified using multivariable logistic regression analyses. The association was described using the adjusted odds ratio (AOR) at a 95% confidence interval (CI). Finally, statistical significance was set at a p-value <0.05. Results Of the 121 medical records of children, 33.9% (95% CI:25–42%) died. Among the survivors, 28.1% were discharged with neurological sequelae and the remains (38.0%) were discharged with normal outcomes. In multivariable analyses, nutritional status (AOR=2.87; 95% CI:1.04–7.94), duration of illness (AOR = 0.33; 95% CI: 0.15–0.86), hydrocephalus (AOR=3.78; 95% CI:1.08–13.34), and stage-III Tuberculous Meningitis (AOR = 5.29; 95% CI:1.88–14.84) were identified as significantly associated factors with poor clinical outcomes. Conclusion The treatment outcomes for tuberculous meningitis in children are unfavorable. Two-thirds of children had poor treatment outcomes. Malnutrition, disease stage, hydrocephalus, and illness duration were associated with poor treatment outcomes at discharge. Health workers in primary health care should be aware of the importance of early screening, diagnosis, and treatment to improve clinical outcomes and reduce associated mortality and disability. In practice, more attention should be paid to children with malnutrition and hydrocephalus.

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Section: Discussionsupporting

confidence: 89%

Tuberculous Meningitis in Children: Treatment Outcomes at Discharge and Its Associated Factors in Eastern Ethiopia: A Five Years Retrospective Study

Abdella¹,

Deginet²,

Weldegebreal³

et al. 2022

IDR

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“…[10][11][12][13][14] Hydrocephalus is also considered a prognostic factor that could predict the poor outcome among TBM patients in a retrospective study from China. 30 The limitation of this study is the use of retrospective data. Further research can be carried out using analytical methods to calculate the significance of the characteristics of TBM with and without hydrocephalus to the outcome.…”

Section: Discussionmentioning

confidence: 98%

Outcomes of Tuberculous Meningitis Patients with or without Hydrocephalus from a Tertiary Hospital in West Java, Indonesia

Zakiyyah

Gunadharma

Ganiem

2022

AMJ

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Background: Tuberculous meningitis (TBM) is a severe form of extrapulmonary tuberculosis. One of the most common complications of TBM is hydrocephalus, with a higher risk of mortality. This study aimed to evaluate the outcome among TBM patients with or without hydrocephalus.Methods: This study was a retrospective cross-sectional comparative analytical study. A total sampling was employed based on the number of traceable resumes of TBM patients treated at the Department of Neurology Dr. Hasan Sadikin General Hospital, Bandung, Indonesia in 2018. Results: Of the 127 data of TBM patients, 55 (43.3%) had hydrocephalus, and 72 (56.7%) did not. The median age of TBM patients with and without hydrocephalus was 34 years (IQR 26–45) and 35 years (IQR 24–44), respectively. Decreased consciousness dominated the clinical symptoms for 94.5% in the hydrocephalus group and 84.7% in the non-hydrocephalus group. Hospital-acquired pneumonia occurred mainly in the hydrocephalus group (29.1%), whereas urinary tract infections mainly occurred in without hydrocephalus group (18%). There was a significant difference between the outcome of hydrocephalus and non-hydrocephalus (p=0.005). Mortality was higher in patients with hydrocephalus compared to those without hydrocephalus.Conclusions: The outcome of TBM patients with hydrocephalus is worse than those without hydrocephalus, as reflected by a higher grade of TBM, higher mortality rate, and lower good recovery upon treatment administration. Therefore, prompt diagnosis and treatment are needed to improve the outcome and survival among TBM patients with hydrocephalus.

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“…hydrocephalus of TBM may be associated a pathogenesis of meningeal exudate and either overproduction of CSF or malfunctioning absorption of CSF in the subarachnoid space [33,34],and is thought to be an important risk factor of poor outcome. the V-P shunt, or CSF drainage is a management way of hydrocephalus [34],however, the therapeutic effect of the V-P shunt, or CSF drainage remains controversial.…”

Section: Discussionmentioning

confidence: 99%

High blood neutrophil-lymphocyte ratio associated with short poor outcome in tuberculous meningitis

Liu

et al. 2022

Preprint

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Background It is difficult to predict the short prognosis of tuberculous meningitis (TBM), no study reported the neutrophil lymphocyte ratio(NLR) as a predictor of short prognosis in TBM and the relationship between NLR and the severity of TBM. We hypothesized that NLR is an indicator to reflect independent prognostic significance in patients with TBM and there is a correlation between NLR and the severity of TBM. This study aimed to know the role of the neutrophil lymphocyte ratio as a predictor of 28-mortality and the relationship with the severity of TBM in patients with TBM. Methods We retrospectively collected data from patients diagnosed with TBM in the West China Hospital, Sichuan University, from the period between January 1st, 2018 and August 1st, 2019. Multivariable analysis was executed by the logistic regression model to verify the independence of the 28-day mortality, Spearman correlation analysis was performed to discuss correlation about and the severity of TBM. Results A total of 231 patients were enrolled. 68 (29.4%) patients were classified as stage I. 142(61.5%) patients were stage II.25(10.8) patients were stage III. 16(6.9%) patients died during the follow-up period of 28 days. By multiple logistic regression analyses, the NLR(OR = 1.066, 95% CI = 1.002–1.133, p = 0.043), peripheral neurological deficit (OR 7.485, 95% CI2.010-27.876, P = 0 .003)and hydrocephalus (OR 11.329, 95% CI 2.395–53.583, P = 0 .002) were associated with the independent risks of 28-day mortality. Spearman correlation analysis showed the severity of TBM was significantly positively correlated with the NLR(r = 0.216, p = 0.01). Conclusions NLR, peripheral neurological deficit and hydrocephalus were independent predictors of short prognosis and NLR was significantly positively correlated with the severity of TBM.

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Old age and hydrocephalus are associated with poor prognosis in patients with tuberculous meningitis

Cited by 13 publications

References 26 publications

Tuberculous Meningitis in Children: Treatment Outcomes at Discharge and Its Associated Factors in Eastern Ethiopia: A Five Years Retrospective Study

Tuberculous Meningitis in Children: Treatment Outcomes at Discharge and Its Associated Factors in Eastern Ethiopia: A Five Years Retrospective Study

Outcomes of Tuberculous Meningitis Patients with or without Hydrocephalus from a Tertiary Hospital in West Java, Indonesia

High blood neutrophil-lymphocyte ratio associated with short poor outcome in tuberculous meningitis

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