Predictors of mortality in tuberculous meningitis: a multivariate analysis of 160 cases.
OBJECTIVE
To evaluate predictors of mortality in 160 patients with tuberculous meningitis (TBM).


METHODS
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.
Yasar
K K
KK
Department of Infectious Diseases and Clinical Microbiology, Haseki Training and Research Hospital, Istanbul, Turkey. kadriyeyasar@hasekihastanesi.gov.tr
Pehlivanoglu
F
F
Sengoz
G
G
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D016009:Chi-Square Distribution; D015897:Comorbidity; D018450:Disease Progression; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D006849:Hydrocephalus / Q000382:microbiology / Q000401:mortality; D007964:Leukocytosis / Q000382:microbiology / Q000401:mortality; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D014390:Tuberculosis, Meningeal / Q000382:microbiology / Q000401:mortality* / Q000523:psychology; D014421:Turkey / Q000453:epidemiology; D055815:Young Adult