Department of Tuberculosis, Beijing Chest Hospital, Capital Medical University, Beijing, China.
Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China.
Front Public Health. 2023 Jan 27;10:1040071. doi: 10.3389/fpubh.2022.1040071. eCollection 2022.
The present study aimed to explore the risk factors for tuberculous meningitis (TBM) among patients with tuberculosis (TB).
This retrospective study was conducted on patients with TB who were hospitalized in Beijing Chest Hospital between January 2012 and December 2019. Demographic and clinical data of patients with TB were extracted from electronic medical records using a standardized data collection system. Logistic regression was used to analyze the risk factors associated with TBM.
Of the total number of 22,988 cases enrolled, 3.1% were cases of TBM, which included 127 definite and 581 probable TBM, respectively. Multivariate analysis showed that definite TBM was significantly associated with patients aged < 30 years [adjusted odds ratio (aOR) = 3.015, 95% confidence interval (CI): (1.451-6.266)], who were farmers [aOR = 1.490, 95%CI: (1.020-2.177)], with miliary pulmonary TB [aOR = 105.842, 95%CI: (71.704-156.235)], and with malnutrition [aOR = 2.466, 95%CI: (1.110-5.479)]. Additionally, probable TBM was significantly associated with patients aged < 30 years [aOR = 2.174, 95% CI: (1.450-3.261)], aged 30-59 years [aOR = 1.670, 95% CI: (1.222-2.282)], who were farmers [aOR = 1.482, 95%CI: (1.203-1.825)], with miliary pulmonary TB [aOR = 108.696, 95%CI: (87.122-135.613)], and with a digestive system TB [aOR = 2.906, 95%CI: (1.762-4.793)].
An age of < 30 years, being a farmer, and having miliary pulmonary TB were risk factors for TBM among patients with TB. Further screening of patients with TB with aforementioned characteristics could facilitate clinicians to identify patients with TBM at an early stage.
本研究旨在探讨结核病(TB)患者中结核性脑膜炎(TBM)的危险因素。
这是一项回顾性研究,纳入了 2012 年 1 月至 2019 年 12 月期间在北京胸科医院住院的 TB 患者。使用标准化数据采集系统从电子病历中提取 TB 患者的人口统计学和临床数据。采用 logistic 回归分析与 TBM 相关的危险因素。
在纳入的 22988 例患者中,3.1%为 TBM 患者,其中确诊 TBM 127 例,可能 TBM 581 例。多因素分析显示,年龄<30 岁(校正比值比[aOR] = 3.015,95%置信区间[CI]:1.451-6.266)、农民(aOR = 1.490,95%CI:1.020-2.177)、粟粒性肺结核(aOR = 105.842,95%CI:71.704-156.235)和营养不良(aOR = 2.466,95%CI:1.110-5.479)与确诊 TBM 显著相关。此外,年龄<30 岁(aOR = 2.174,95%CI:1.450-3.261)、30-59 岁(aOR = 1.670,95%CI:1.222-2.282)、农民(aOR = 1.482,95%CI:1.203-1.825)、粟粒性肺结核(aOR = 108.696,95%CI:87.122-135.613)和消化系统 TB(aOR = 2.906,95%CI:1.762-4.793)与可能 TBM 显著相关。
年龄<30 岁、农民和粟粒性肺结核是 TB 患者发生 TBM 的危险因素。进一步对具有上述特征的 TB 患者进行筛查,有助于临床医生早期识别 TBM 患者。