Tuberculous meningitis (TBM) is the most common form of central nervous system tuberculosis with a very poor prognosis. We aimed at assessing risk factors related to the prognosis of patients with TBM.Forty-five inpatients with TBM in our institution from January 2013 to December 2015 were enrolled retrospectively. The good or poor prognosis in the patients was defined, based on Glasgow Outcome Scale System at discharge. Patients with a GOS score less than 5 were defined as "poor prognosis." Univariate and multivariate logistic regression analyses were performed to assess the predictors for TBM outcome.Among 45 TBM patients, 35 (77.8%) and 10 (22.2%) were in good, poor prognoses, respectively. Old age, disturbance of consciousness, moderate to severe electroencephalogram abnormality, hydrocephalus, remarkable increase of protein (≥ 236 mg/dL) and white blood cell counts (≥ 243 /μL) in cerebral spinal fluid were associated with poor prognosis. Multivariate analysis indicated that old age (odds ratio (OR) = 18.395, P = .036) and hydrocephalus (OR = 32.995, P = .049) were independent factors for a poor outcome of TBM.In conclusion, old age and hydrocephalus are the predictors for poor prognosis of TBM. Patients with these risk factors should be treated promptly with a special care paid to improve their outcomes.

译文

结核性脑膜炎 (TBM) 是中枢神经系统结核病的最常见形式,预后很差。我们旨在评估与TBM患者预后相关的危险因素。我们机构从2013年1月到2015年12月的45例TBM住院患者被回顾性纳入。根据出院时格拉斯哥结局量表系统,确定了患者的良好或不良预后。GOS评分小于5的患者被定义为 “不良预后”。进行单因素和多因素logistic回归分析以评估TBM结果的预测因素。在45例TBM患者中,分别有35例 (77.8% 例) 和10例 (22.2% 例) 预后良好。年龄大、意识障碍、中重度脑电图异常、脑积水、脑脊液中蛋白质 (≥ 236  mg/dL) 和白细胞计数 (≥ 243  /μ l) 均与预后不良相关。多因素分析显示,高龄 (优势比 (OR)  =   18.395,p   =  .036) 和脑积水 (OR   =   32.995,p   =  .049) 是TBM预后不良的独立因素。老年和脑积水是TBM预后不良的预测因素。具有这些危险因素的患者应及时接受特殊护理治疗,以改善其预后。

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