title: Long-term mortality in patients with tuberculous meningitis: a Danish nationwide cohort study.
abstract: BACKGROUND
  With high short-term mortality and substantial excess morbidity among survivors, tuberculous meningitis (TBM) is the most severe manifestation of extra-pulmonary tuberculosis (TB). The objective of this study was to assess the long-term mortality and causes of death in a TBM patient population compared to the background population.
  
  
  METHODS
  A nationwide cohort study was conducted enrolling patients notified with TBM in Denmark from 1972-2008 and alive one year after TBM diagnosis. Data was extracted from national registries. From the background population we identified a control cohort of individuals matched on gender and date of birth. Kaplan-Meier survival curves and Cox regression analysis were used to estimate mortality rate ratios (MRR) and analyse causes of death.
  
  
  RESULTS
  A total of 55 TBM patients and 550 individuals from the background population were included in the study. Eighteen patients (32.7%) and 107 population controls (19.5%) died during the observation period. The overall MRR was 1.79 (95%CI: 1.09-2.95) for TBM patients compared to the population control cohort. TBM patients in the age group 31-60 years at time of diagnosis had the highest relative risk of death (MRR 2.68; 95%CI 1.34-5.34). The TBM patients had a higher risk of death due to infectious disease, but not from other causes of death.
  
  
  CONCLUSIONS
  Adult TBM patients have an almost two-fold increased long-term mortality and the excess mortality stems from infectious disease related causes of death.
authors: Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark. annesophiechristensen@gmail.com
authors: Anne-Sophie Halkjær
authors: AS
authors: Christensen
authors: Casper
authors: C
authors: Roed
authors: Lars Haukali
authors: LH
authors: Omland
authors: Peter Henrik
authors: PH
authors: Andersen
authors: Niels
authors: N
authors: Obel
authors: Åse Bengaard
authors: ÅB
authors: Andersen
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D015331:Cohort Studies; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D014390:Tuberculosis, Meningeal / Q000401:mortality*