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. 2011;6(11):e27900.
doi: 10.1371/journal.pone.0027900. Epub 2011 Nov 22.

Long-term mortality in patients with tuberculous meningitis: a Danish nationwide cohort study

Anne-Sophie Halkjær Christensen  1 , Casper Roed, Lars Haukali Omland, Peter Henrik Andersen, Niels Obel, Åse Bengaard Andersen
Affiliations

Long-term mortality in patients with tuberculous meningitis: a Danish nationwide cohort study

Anne-Sophie Halkjær Christensen et al. PLoS One. 2011.

Abstract

Background: With high short-term mortality and substantial excess morbidity among survivors, tuberculous meningitis (TBM) is the most severe manifestation of extra-pulmonary tuberculosis (TB). The objective of this study was to assess the long-term mortality and causes of death in a TBM patient population compared to the background population.

Methods: A nationwide cohort study was conducted enrolling patients notified with TBM in Denmark from 1972-2008 and alive one year after TBM diagnosis. Data was extracted from national registries. From the background population we identified a control cohort of individuals matched on gender and date of birth. Kaplan-Meier survival curves and Cox regression analysis were used to estimate mortality rate ratios (MRR) and analyse causes of death.

Findings: A total of 55 TBM patients and 550 individuals from the background population were included in the study. Eighteen patients (32.7%) and 107 population controls (19.5%) died during the observation period. The overall MRR was 1.79 (95%CI: 1.09-2.95) for TBM patients compared to the population control cohort. TBM patients in the age group 31-60 years at time of diagnosis had the highest relative risk of death (MRR 2.68; 95%CI 1.34-5.34). The TBM patients had a higher risk of death due to infectious disease, but not from other causes of death.

Conclusion: Adult TBM patients have an almost two-fold increased long-term mortality and the excess mortality stems from infectious disease related causes of death.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Kaplan-Meier survival curve of patients with tuberculous meningitis (dashed line) and population controls (solid line), Denmark, 1972–2008.
See this image and copyright information in PMC

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