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Abstract：
OBJECTIVE: To investigate risk factors associated with long-term mortality in patients with stage II and III tuberculous meningitis (TBM).
METHODS: This retrospective analysis examined patients who were first diagnosed with stage II and III TBM at West China Hospital of Sichuan University between January 1, 2018 and October 1, 2019. Patients were followed via telephone and categorized into survival and mortality groups based on 4-year outcomes. Multivariate logistic regression identified independent risk factors for long-term mortality in stage II and III TBM.
RESULTS: In total, 178 patients were included, comprising 108 (60.7%) males and 36 (20.2%) non-survivors. Mean age was 36 ± 17 years. Compared to survivors, non-survivors demonstrated significantly higher age, heart rate, diastolic blood pressure, blood glucose, rates of headache, neurological deficits, cognitive dysfunction, impaired consciousness, hydrocephalus, and basal meningeal inflammation. This group also exhibited significantly lower Glasgow Coma Scale (GCS) scores, blood potassium, albumin, and cerebrospinal fluid chloride. Multivariate analysis revealed age (OR 1.042; 95% CI 1.015-1.070; P = 0.002), GCS score (OR 0.693; 95% CI 0.589-0.814; P < 0.001), neurological deficits (OR 5.204; 95% CI 2.056-13.174; P < 0.001), and hydrocephalus (OR 2.680; 95% CI 1.081-6.643; P = 0.033) as independent mortality risk factors. The ROC curve area under age was 0.613 (95% CI 0.506-0.720; P = 0.036) and 0.721 (95% CI 0.615-0.826; P < 0.001) under GCS score.
CONCLUSIONS: Advanced age, reduced GCS scores, neurological deficits, and hydrocephalus were identified as independent risk factors for mortality in stage II and III TBM patients.
METHODS: This retrospective analysis examined patients who were first diagnosed with stage II and III TBM at West China Hospital of Sichuan University between January 1, 2018 and October 1, 2019. Patients were followed via telephone and categorized into survival and mortality groups based on 4-year outcomes. Multivariate logistic regression identified independent risk factors for long-term mortality in stage II and III TBM.
RESULTS: In total, 178 patients were included, comprising 108 (60.7%) males and 36 (20.2%) non-survivors. Mean age was 36 ± 17 years. Compared to survivors, non-survivors demonstrated significantly higher age, heart rate, diastolic blood pressure, blood glucose, rates of headache, neurological deficits, cognitive dysfunction, impaired consciousness, hydrocephalus, and basal meningeal inflammation. This group also exhibited significantly lower Glasgow Coma Scale (GCS) scores, blood potassium, albumin, and cerebrospinal fluid chloride. Multivariate analysis revealed age (OR 1.042; 95% CI 1.015-1.070; P = 0.002), GCS score (OR 0.693; 95% CI 0.589-0.814; P < 0.001), neurological deficits (OR 5.204; 95% CI 2.056-13.174; P < 0.001), and hydrocephalus (OR 2.680; 95% CI 1.081-6.643; P = 0.033) as independent mortality risk factors. The ROC curve area under age was 0.613 (95% CI 0.506-0.720; P = 0.036) and 0.721 (95% CI 0.615-0.826; P < 0.001) under GCS score.
CONCLUSIONS: Advanced age, reduced GCS scores, neurological deficits, and hydrocephalus were identified as independent risk factors for mortality in stage II and III TBM patients.
摘要：
目的：探讨与II期和III期结核性脑膜炎（TBM）患者长期死亡率相关的危险因素。
方法：本回顾性分析2018年1月1日至2019年10月1日在四川大学华西医院首次诊断为II期和III期TBM的患者。通过电话对患者进行随访，并根据4年结局分为生存和死亡组。多因素logistic回归确定了II期和III期TBM长期死亡的独立危险因素。
结果：总计，178名患者被纳入，包括108名（60.7%）男性和36名（20.2%）非幸存者。平均年龄36±17岁。与幸存者相比，非幸存者表现出明显更高的年龄，心率,舒张压,血糖，头痛的发生率，神经功能缺损,认知功能障碍，意识受损，脑积水,和基底脑膜炎症。该组还表现出显着较低的格拉斯哥昏迷量表（GCS）得分，血钾,白蛋白,和脑脊液氯化物。多因素分析显示年龄(OR1.042;95%CI1.015-1.070;P=0.002),GCS评分(OR0.693;95%CI0.589-0.814;P<0.001),神经功能缺损（OR5.204；95％CI2.056-13.174；P<0.001），和脑积水（OR2.680；95％CI1.081-6.643；P=0.033）是独立的死亡危险因素。GCS评分下ROC曲线面积为0.613（95％CI0.506-0.720；P=0.036）和0.721（95％CI0.615-0.826；P<0.001）。
结论：高龄，GCS分数降低，神经功能缺损,和脑积水被确定为II期和III期TBM患者死亡的独立危险因素。
方法：本回顾性分析2018年1月1日至2019年10月1日在四川大学华西医院首次诊断为II期和III期TBM的患者。通过电话对患者进行随访，并根据4年结局分为生存和死亡组。多因素logistic回归确定了II期和III期TBM长期死亡的独立危险因素。
结果：总计，178名患者被纳入，包括108名（60.7%）男性和36名（20.2%）非幸存者。平均年龄36±17岁。与幸存者相比，非幸存者表现出明显更高的年龄，心率,舒张压,血糖，头痛的发生率，神经功能缺损,认知功能障碍，意识受损，脑积水,和基底脑膜炎症。该组还表现出显着较低的格拉斯哥昏迷量表（GCS）得分，血钾,白蛋白,和脑脊液氯化物。多因素分析显示年龄(OR1.042;95%CI1.015-1.070;P=0.002),GCS评分(OR0.693;95%CI0.589-0.814;P<0.001),神经功能缺损（OR5.204；95％CI2.056-13.174；P<0.001），和脑积水（OR2.680；95％CI1.081-6.643；P=0.033）是独立的死亡危险因素。GCS评分下ROC曲线面积为0.613（95％CI0.506-0.720；P=0.036）和0.721（95％CI0.615-0.826；P<0.001）。
结论：高龄，GCS分数降低，神经功能缺损,和脑积水被确定为II期和III期TBM患者死亡的独立危险因素。
