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. 2021 Aug 10;21(1):308.
doi: 10.1186/s12883-021-02340-3.

Prognostic factors of adult tuberculous meningitis in intensive care unit: a single-center retrospective study in East China

Baobao Feng  1   2 , Xiao Fei  3 , Ying Sun  4 , Xingguo Zhang  1   2 , Deya Shang  1   2 , Yi Zhou  1   2 , Meiyan Sheng  4 , Jiarui Xu  1   2 , Wei Zhang  1   2 , Wanhua Ren  5   6
Affiliations

Prognostic factors of adult tuberculous meningitis in intensive care unit: a single-center retrospective study in East China

Baobao Feng et al. BMC Neurol. .

Erratum in

Abstract

Background: Tuberculous meningitis (TBM) is the most lethal form of tuberculosis worldwide. Data on critically ill TBM patients in the intensive care unit (ICU) of China are lacking. We tried to identify prognostic factors of adult TBM patients admitted to ICU in China.

Methods: We conducted a retrospective study on adult TBM in ICU between January 2008 and April 2018. Factors associated with unfavorable outcomes at 28 days were identified by logistic regression. Factors associated with 1-year mortality were studied by Cox proportional hazards modeling.

Results: Eighty adult patients diagnosed with TBM (age 38.5 (18-79) years, 45 (56 %) males) were included in the study. An unfavorable outcome was observed in 39 (49 %) patients and were independently associated with Acute Physiology and Chronic Health Evaluation (APACHE) II > 23 (adjusted odds ratio (aOR) 5.57, 95 % confidence interval (CI) 1.55-19.97), Sequential Organ Failure Assessment (SOFA) > 8 (aOR 9.74, 95 % CI 1.46-64.88), and mechanical ventilation (aOR 18.33, 95 % CI 3.15-106.80). Multivariate Cox regression analysis identified two factors associated with 1-year mortality: APACHE II > 23 (adjusted hazard ratio (aHR) 4.83; 95 % CI 2.21-10.55), and mechanical ventilation (aHR 9.71; 95 % CI 2.31-40.87).

Conclusions: For the most severe adult TBM patients of Medical Research Council (MRC) stage III, common clinical factors aren't effective enough to predict outcomes. Our study demonstrates that the widely used APACHE II and SOFA scores on admission can be used to predict short-term outcomes, while APACHE II could also be used to predict long-term outcomes of adult patients with TBM in ICU.

Keywords: Intensive care unit; Prognostic factors; Tuberculous meningitis.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Kaplan-Meier estimates of overall survival at 1 year. ICU, intensive care unit
Fig. 2
Fig. 2
ROC curves for GCS, APACHE II and SOFA. ROC, receiver operating characteristic; GCS, Glasgow Coma Scale; APACHE, Acute Physiology and Chronic Health Evaluation; SOFA, Sequential Organ Failure Assessment; AUC, area under the curve
Fig. 3
Fig. 3
Kaplan-Meier survival curves of patients with APACHE II ≤ 23 and > 23. P (log rank test) < 0.001. APACHE, Acute Physiology and Chronic Health Evaluation; ICU, intensive care unit
See this image and copyright information in PMC

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