Outcome of tuberculous meningitis at 6 and 12 months: a multiple regression analysis

Abstract

Objective: There are few studies on the long-term outcome of tuberculous meningitis (TBM) employing multivariate analysis. The present study was undertaken to evaluate the outcome predictors of TBM at 6 and 12 months.

Method: Those patients with TBM who could be sequentially followed up for 6 and 12 months were included in this prospective, hospital-based study. The outcome was defined at 6 and 12 months by Barthel Index (BI) score into complete (BI = 20), partial (BI = 12-19) and poor (BI<12). Death was included in the 'poor recovery' group for statistical analysis. A number of clinical, laboratory and radiological parameters were evaluated by multiple regression analysis.

Results: Fifty-eight patients with TBM aged between 1 and 64 years (mean 25.6 years), 18 of whom were females and 17 children below 12 years, were included in the study. Fifty-eight patients were followed up for 6 months and 56 for 12 months. At 6 months' follow-up 37 patients had complete recovery, three partial, six poor and 12 had died. At 12 months, 40 patients had complete recovery, one partial and three poor. The best set of parameters predicting outcome at 6 and 12 months included stage of TBM, Glasgow coma scale (GCS) and brain infarction.

Conclusion: This study highlights the importance of stage of meningitis, GCS and infarction in predicting the long term outcome of tuberculous meningitis.