title: Risk factors associated with poor outcomes in patients with brain abscesses.
abstract: OBJECTIVE
  The purpose of this study was to describe the clinical characteristics, treatment outcomes, and prognostic factors in patients with brain abscesses treated in a single institute during a recent 10-year period.
  
  
  METHODS
  Fifty-one patients with brain abscesses who underwent navigation-assisted abscess aspiration with antibiotic treatment were included in this study. Variable parameters were collected from the patients' medical records and radiological data. A comparison was made between patients with favorable [Glasgow Outcome Scale (GOS) ≥4] and unfavorable (GOS <4) outcomes at discharge. Additionally, we investigated the factors influencing the duration of antibiotic administration.
  
  
  RESULTS
  The study included 41 male and 10 female patients with a mean age of 53 years. At admission, 42 patients (82%) showed either clear or mildly disturbed consciousness (GCS ≥13) and 24 patients (47%) had predisposing factors. The offending microorganisms were identified in 25 patients (49%), and Streptococcus species were the most commonly isolated bacteria (27%). The mean duration of antibiotic administration was 42 days. At discharge, 41 patients had a favorable outcome and 10 had an unfavorable outcome including 8 deaths. The decreased level of consciousness (GCS <13) on admission was likely associated with an unfavorable outcome (p=0.052), and initial hyperglycemia (≥140 mg/dL) was an independent risk factor for prolonged antibiotic therapy (p=0.032).
  
  
  CONCLUSIONS
  We found that the level of consciousness at admission was associated with treatment outcomes in patients with brain abscesses. Furthermore, initial hyperglycemia was closely related to the long-term use of antibiotic agents.
authors.affiliation: Department of Neurosurgery, Korea University Medical Center, College of Medicine, Korea University, Seoul, Korea.
authors.forename: Seok-Jin
authors.initials: SJ
authors.lastname: Ko
authors.affiliation: Department of Neurosurgery, Korea University Medical Center, College of Medicine, Korea University, Seoul, Korea.
authors.forename: Kyung-Jae
authors.initials: KJ
authors.lastname: Park
authors.affiliation: Department of Neurosurgery, Korea University Medical Center, College of Medicine, Korea University, Seoul, Korea.
authors.forename: Dong-Hyuk
authors.initials: DH
authors.lastname: Park
authors.affiliation: Department of Neurosurgery, Korea University Medical Center, College of Medicine, Korea University, Seoul, Korea.
authors.forename: Shin-Hyuk
authors.initials: SH
authors.lastname: Kang
authors.affiliation: Department of Neurosurgery, Korea University Medical Center, College of Medicine, Korea University, Seoul, Korea.
authors.forename: Jung-Yul
authors.initials: JY
authors.lastname: Park
authors.affiliation: Department of Neurosurgery, Korea University Medical Center, College of Medicine, Korea University, Seoul, Korea.
authors.forename: Yong-Gu
authors.initials: YG
authors.lastname: Chung
keywords: Brain abscess; Glasgow Coma Scale; Glasgow Outcome Scale; Hyperglycemia