Guo Can, Liu Ke-Wei, Tong Jing, Gao Meng-Qiu
Department of Tuberculosis, The First Affiliated Hospital of Xinxiang Medical University, Weihui, Henan, China.
Department of Tuberculosis, Beijing Chest Hospital, Capital Medical University/Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, China.
Front Public Health. 2025 Mar 12;12:1391821. doi: 10.3389/fpubh.2024.1391821. eCollection 2024.
The residual risk of mortality or neurological disability is high in tuberculous meningitis (TBM), but there are not many effective treatments for TBM. Malnutrition is a modifiable risk factor for patients with tuberculous; however, the relationship between nutritional risk and neurological prognosis is not clear. In the present study, we aimed to explore the association between malnutrition risk and neurological outcome in patients with TBM.
A retrospective cohort study was conducted from December 2010 to January 2021. Malnutrition risks were evaluated by nutritional scales, including controlling nutritional status score (CONUT), geriatric nutritional risk index (GNRI), and prognostic nutritional index (PNI). The primary outcome was a poor recovery measured by a modified Rankin Scale (mRS) at 1-year follow-up. Malnutrition risk was estimated, and the association between malnutrition and follow-up outcome was analyzed.
A total of 401 participants were analyzed in the study. According to CONUT, GNRI, and PNI, 299(74.56%), 231(57.61%), and 107(26.68%) patients were with malnutrition risk on admission. At 1-year follow-up, a total of 115 patients (28.67%) were with poor recovery. After adjustment for confounding factors, the association between moderate malnutrition (OR = 1.59, 95% CI 1.00-3.59, = 0.050) and severe malnutrition (OR = 3.76, 95% CI 1.03-12.63, = 0.049) was estimated by CONUT and was significantly associated with poor outcome. For each point increase in COUNT score (OR = 1.12, 95% CI 1.00-1.27, = 0.059), the odds of poor functional recovery increased by 12%.
Malnutrition in TBM patients was related to an increased risk of poor neurological recovery in the long-term follow-up. Our study stressed the importance of assessing malnutrition in TBM patients.
结核性脑膜炎（TBM）患者的死亡或神经功能残疾残留风险很高，但针对TBM的有效治疗方法并不多。营养不良是结核病患者的一个可改变的风险因素；然而，营养风险与神经预后之间的关系尚不清楚。在本研究中，我们旨在探讨TBM患者营养不良风险与神经结局之间的关联。
进行了一项回顾性队列研究，时间跨度为2010年12月至2021年1月。通过营养量表评估营养不良风险，包括控制营养状况评分（CONUT）、老年营养风险指数（GNRI）和预后营养指数（PNI）。主要结局是在1年随访时用改良Rankin量表（mRS）衡量的恢复不佳。估计营养不良风险，并分析营养不良与随访结局之间的关联。
本研究共分析了401名参与者。根据CONUT、GNRI和PNI，分别有299名（74.56%）、231名（57.61%）和107名（26.68%）患者入院时存在营养不良风险。在1年随访时，共有115名患者（28.67%）恢复不佳。在调整混杂因素后，CONUT评估显示中度营养不良（OR = 1.59，95%CI 1.00 - 3.59，P = 0.050）和重度营养不良（OR = 3.76，95%CI 1.03 - 12.63，P = 0.049）与不良结局显著相关。CONUT评分每增加1分（OR = 1.12，95%CI 1.00 - 1.27，P = 0.059），功能恢复不佳的几率增加12%。
TBM患者的营养不良与长期随访中神经功能恢复不佳的风险增加有关。我们的研究强调了评估TBM患者营养不良的重要性。
