Department of Neurology, Government Medical College, Thiruvananthapuram, Kozhikode, India.
Neurol India. 2012 Jan-Feb;60(1):18-22. doi: 10.4103/0028-3886.93583.
Meningeal tuberculosis (TB) has higher mortality compared to other forms of central nervous system TB. However, data on predictors of mortality is limited.
To determine the predictors of mortality in patients with meningeal TB.
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.
Univariate analysis and multinomial logistic regression was done.
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.
Identification of factors predictive of in-hospital mortality will help to prognosticate patients with meningeal TB at the time of admission.
与其他形式的中枢神经系统结核相比，脑膜结核的死亡率更高。然而，关于死亡预测因素的数据有限。
确定脑膜结核患者死亡的预测因素。
本研究回顾性分析了 2006 年 1 月至 2008 年 12 月期间因脑膜结核住院的患者数据。使用 Thwaites 指数评分作为脑膜结核的诊断标准，该评分是用于对二分类临床变量进行加权诊断的指数评分。分别分析了 HIV 感染者和非 HIV 感染者的死亡预测因素。
进行了单因素分析和多项逻辑回归分析。
单因素分析显示，年龄>40 岁、格拉斯哥昏迷量表（GCS）评分<8、无头痛、脑脊液（CSF）蛋白≤60mg%和入院时 MRC 分期 III 是预测院内死亡率的因素。在多因素逻辑回归分析中，当包括 HIV 患者时（P=0.049），年龄>40 岁是死亡的危险因素，当排除 HIV 患者时（P=0.048）也是如此。当包括 HIV 阳性者（P=0.011）和阴性者（P=0.004）时，CSF 蛋白≥60mg%被发现是一个显著的危险因素。HIV 血清阳性、类固醇治疗或治疗延迟不会影响死亡率。
识别与住院死亡率相关的因素将有助于在入院时对脑膜结核患者进行预后评估。
