Clinical features, long-term clinical outcomes, and prognostic factors of tuberculous meningitis in West China: a multivariate analysis of 154 adults.
Tuberculosis is prevalent in China, which is the second greatest contributor to the global tuberculosis burden. Tuberculosis meningitis (TBM) is the most severe disease form but few reports describe long-term clinical outcomes and prognostic factors. Thus, we studied these features in Chinese TBM patients.



A retrospective follow-up study was used to collect clinical features and outcomes of adult TB meningitis at the First Affiliated Hospital of Chongqing Medical University from June 2012 to August 2015. Univariate analysis and multivariate analysis were used to identify predictive factors associated with outcomes at discharge and follow-up.



TBM patients (N = 154) were a median age of 41 years (range: 16-82 years). Median time to follow-up was 26.4 months (range: 9.3-46.5 months) and 31% had poor outcomes at follow-up and limb weakness (p = 0.016), lower GCS scores (p < 0.001), cranial-nerve palsy (p = 0.024), and hydrocephalus (p = 0.009) were closely associated with these poor outcomes. Furthermore, a high neutrophil to lymphocytes ratio, high D-dimer, a low albumin to globulin ratio and slow background of EEG associated with poor outcomes as well.



Mortality and disability associated with TBM are high in China. Limb weakness, GCS scores, cranial-nerve palsy and hydrocephalus were independent predictors of poor outcomes, and AGR, NLR, D-dimer, and EEG abnormalities may be prognostic factors of TBM.
a Department of Neurology, Chongqing Key Laboratory of Neurology , The First Affiliated Hospital of Chongqing Medical University , Chongqing , China.
Kunyi
K
Li
b Department of Critical Care Medicine , The First Affiliated Hospital of Chongqing Medical University , Chongqing , China.
Hong
H
Tang
a Department of Neurology, Chongqing Key Laboratory of Neurology , The First Affiliated Hospital of Chongqing Medical University , Chongqing , China.
Yi
Y
Yang
a Department of Neurology, Chongqing Key Laboratory of Neurology , The First Affiliated Hospital of Chongqing Medical University , Chongqing , China.
Qin
Q
Li
a Department of Neurology, Chongqing Key Laboratory of Neurology , The First Affiliated Hospital of Chongqing Medical University , Chongqing , China.
Yuchuan
Y
Zhou
a Department of Neurology, Chongqing Key Laboratory of Neurology , The First Affiliated Hospital of Chongqing Medical University , Chongqing , China.
Min
M
Ren
a Department of Neurology, Chongqing Key Laboratory of Neurology , The First Affiliated Hospital of Chongqing Medical University , Chongqing , China.
Xianghua
X
Long
a Department of Neurology, Chongqing Key Laboratory of Neurology , The First Affiliated Hospital of Chongqing Medical University , Chongqing , China.
Wenjing
W
Shen
a Department of Neurology, Chongqing Key Laboratory of Neurology , The First Affiliated Hospital of Chongqing Medical University , Chongqing , China.
Rong
R
Hu
a Department of Neurology, Chongqing Key Laboratory of Neurology , The First Affiliated Hospital of Chongqing Medical University , Chongqing , China.
Xuefeng
X
Wang
a Department of Neurology, Chongqing Key Laboratory of Neurology , The First Affiliated Hospital of Chongqing Medical University , Chongqing , China.
Kebin
K
Zeng
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000995:Antitubercular Agents / Q000627:therapeutic use*; D002681:China; D000069280:Electrocorticography; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism; D005500:Follow-Up Studies; D006801:Humans; D006849:Hydrocephalus / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology; D008214:Lymphocytes / Q000187:drug effects / Q000276:immunology / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009169:Mycobacterium tuberculosis / Q000187:drug effects* / Q000254:growth & development / Q000472:pathogenicity; D009504:Neutrophils / Q000187:drug effects / Q000276:immunology / Q000382:microbiology; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012709:Serum Albumin / Q000378:metabolism; D012712:Serum Globulins / Q000378:metabolism; D020432:Trochlear Nerve Diseases / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D014390:Tuberculosis, Meningeal / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology
D000995:Antitubercular Agents; D005338:Fibrin Fibrinogen Degradation Products; D012709:Serum Albumin; D012712:Serum Globulins; C036309:fibrin fragment D
Tuberculosis; clinical features; meningitis; outcome; predictive factor