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Neurol India. 2012 Jan-Feb;60(1):18-22. doi: 10.4103/0028-3886.93583.

Predictors of mortality in patients with meningeal tuberculosis.

Author information

1
Department of Neurology, Government Medical College, Thiruvananthapuram, Kozhikode, India.

Abstract

BACKGROUND:

Meningeal tuberculosis (TB) has higher mortality compared to other forms of central nervous system TB. However, data on predictors of mortality is limited.

AIMS:

To determine the predictors of mortality in patients with meningeal TB.

MATERIALS AND METHODS:

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.

STATISTICAL ANALYSIS:

Univariate analysis and multinomial logistic regression was done.

RESULTS:

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.

CONCLUSIONS:

Identification of factors predictive of in-hospital mortality will help to prognosticate patients with meningeal TB at the time of admission.

PMID:
22406774
DOI:
10.4103/0028-3886.93583
[Indexed for MEDLINE]
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