| Autor: |
S, Hosoglu, M F, Geyik, I, Balik, B, Aygen, S, Erol, T G, Aygencel, A, Mert, N, Saltoglu, I, Dokmetas, S, Felek, M, Sunbul, H, Irmak, K, Aydin, O F, Kokoglu, H, Ucmak, M, Altindis, M, Loeb |
| Rok vydání: |
2002 |
| Předmět: |
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| Zdroj: |
The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease. 6(1) |
| ISSN: |
1027-3719 |
| Popis: |
To assess predictors of mortality and neurological sequelae in patients with tuberculous meningitis (TBM).Patients with TBM treated at 12 university hospitals in Turkey between 1985 and 1997 were evaluated using a standardised protocol applied retrospectively. Variables associated with hospital mortality as well as with the presence of neurological sequelae at 6 months were determined using logistic regression models.Four hundred and thirty-four patients between the ages of 13 and 83 years (mean 33 years) were evaluated. Sixty-eight per cent of these patients presented with Medical Research Council Stage II or III. One hundred and one patients (23.3%) died and 67 (27%) of evaluable survivors had neurological sequelae. In multi-variable analysis, convulsion (OR 3.3, 95%CI 1.2-9.0, P = 0.02), comatose mental status (OR 6.0, 95%CI 3.6-10.2, P = 0.01), and delayed or interrupted treatment (OR 5.1, 95%CI 2.4-11.2, P = 0.01) were shown to be predictors for mortality. The presence of extra-meningeal tuberculosis (OR 2.1, 95%CI 1.1-4.2, P = 0.035), cranial nerve palsy (OR 2.6, 95%CI 1.4-4.2, P = 0.01), hemiparesia/focal weakness (OR 9.3, 95%CI 3.8-22.6, P = 0.01), hemiplegia/multiple neurological deficit (OR 7.1, 95%CI 2.14-23.38, P = 0.01) and drowsiness (OR 4.2, 95%CI 2.04-8.82, P = 0.01) were independent predictors of neurological sequelae at 6 months following hospital discharge.The results of this study emphasise the importance of prompt and uninterrupted anti-tuberculosis therapy for tuberculous meningitis. The presence of seizures or coma on admission to hospital are important predictors for mortality, while the presence of focal neurological signs is a predictor for persistent neurological sequelae in survivors. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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