Department of Pediatrics, Qilu Hospital, Cheeloo College of Medicine, Shandong University, 107#, Wenhuaxi Road, Jinan, 250012, Shandong, China.
Department of Lab Medicine, Shandong Provincial Chest Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.
Sci Rep. 2021 Apr 21;11(1):8654. doi: 10.1038/s41598-021-87082-5.
Tuberculous meningitis (TBM) remains a serious disease for children and its risk factors of poor outcome remain unclear. Therefore, a retrospective study was conducted aiming to investigate the risk factors associated with poor outcome of childhood TBM. Between January 2006 and December 2019, consecutive children patients (≤ 15 years old) who had a diagnosis of TBM were included for the analysis. The demographic, clinical, laboratory, and radiographic data were collected from the electronic medical records retrospectively. Poor outcome was defined as death or transfer to a higher-level hospital. Patients were then divided into good and poor outcome groups. Subsequently, risk factors for poor outcome were estimated using univariate and multivariate logistic regression analysis. A total of 149 children with TBM was enrolled, twenty-two patients suffered poor outcome, including 16 transfers to a higher-level hospital and 6 deaths, and the remaining 127 patients were classified as good outcome group. Further multivariate analysis revealed that coma (age- and sex-adjusted OR = 6.425, 95% CI: 1.743, 23.676; P < 0.01) and cerebrospinal fluid (CSF) protein (> 1188.3 mg/L; age- and sex-adjusted OR = 4.680, 95% CI: 1.469, 14.902; P < 0.01) were associated with the poor outcome of childhood TBM. Childhood TBM remains to have a high mortality rate in China. High CSF protein and coma were identified as risk factors for poor outcome of childhood TBM. Hence, more attention is required to be paid to suspected patients with such characteristics, thus facilitating access to optimum treatment.
结核性脑膜炎（TBM）仍然是儿童的严重疾病，其不良预后的危险因素仍不清楚。因此，进行了一项回顾性研究，旨在调查与儿童 TBM 不良预后相关的危险因素。2006 年 1 月至 2019 年 12 月，连续纳入患有 TBM 的儿童（≤15 岁）患者进行分析。从电子病历中回顾性收集人口统计学、临床、实验室和影像学数据。不良预后定义为死亡或转至更高一级医院。随后，将患者分为预后良好和不良预后组。然后，使用单变量和多变量逻辑回归分析估计不良预后的危险因素。共纳入 149 例 TBM 患儿，22 例患儿预后不良，包括 16 例转至更高一级医院和 6 例死亡，其余 127 例患儿为预后良好组。进一步的多变量分析显示，昏迷（年龄和性别调整后的 OR=6.425，95%CI：1.743，23.676；P<0.01）和脑脊液（CSF）蛋白（>1188.3mg/L；年龄和性别调整后的 OR=4.680，95%CI：1.469，14.902；P<0.01）与儿童 TBM 的不良预后相关。中国儿童 TBM 的死亡率仍然很高。高 CSF 蛋白和昏迷被确定为儿童 TBM 不良预后的危险因素。因此，需要对具有这些特征的疑似患者给予更多关注，从而为患者提供最佳治疗。
