title: Predictors of mortality in patients with meningeal tuberculosis.
abstract: BACKGROUND
  Meningeal tuberculosis (TB) has higher mortality compared to other forms of central nervous system TB. However, data on predictors of mortality is limited.
  
  
  OBJECTIVE
  To determine the predictors of mortality in patients with meningeal TB.
  
  
  METHODS
  This study retrospectively analyzed the data of patients admitted with a diagnosis of meningeal TB between January 2006 and December 2008. Thwaites' index score of four or less was used for the diagnosis of meningeal TB which is a weighted diagnostic index score for dichotomised clinical variables. Predictors of mortality were analyzed separately for both patients with human immunodeficiency virus (HIV) infection and without.
  
  
  METHODS
  Univariate analysis and multinomial logistic regression was done.
  
  
  RESULTS
  Univariate analysis showed age >40 years, Glasgow Coma Scale (GCS) score <8, absence of headache, cerebrospinal fluid (CSF) protein ≤60 mg% and Medical Research Council (MRC) Stage III at presentation to predict in-hospital mortality. In multinomial logistic regression age >40 years was a risk factor for mortality when HIV patients were included (P=0.049) as well as when they were excluded (P=0.048). CSF protein ͳ 60 mg% was found to be a significant risk factor when both HIV seropositive persons (P=0.011) as well as seronegative persons (P=0.004) were included. HIV seropositivity, steroid treatment or delay in treatment did not affect mortality.
  
  
  CONCLUSIONS
  Identification of factors predictive of in-hospital mortality will help to prognosticate patients with meningeal TB at the time of admission.
authors.affiliation: Department of Neurology, Government Medical College, Thiruvananthapuram, Kozhikode, India.
authors.forename: Elizabeth Litta
authors.initials: EL
authors.lastname: George
authors.forename: Thomas
authors.initials: T
authors.lastname: Iype
authors.forename: Ajith
authors.initials: A
authors.lastname: Cherian
authors.forename: Sinchu
authors.initials: S
authors.lastname: Chandy
authors.forename: Aswini
authors.initials: A
authors.lastname: Kumar
authors.forename: Ajitha
authors.initials: A
authors.lastname: Balakrishnan
authors.forename: K
authors.initials: K
authors.lastname: Vijayakumar
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000150:complications / Q000401:mortality; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D015600:Glasgow Coma Scale; D006261:Headache / Q000209:etiology; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D014390:Tuberculosis, Meningeal / Q000150:complications / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy