van Laarhoven et al reported risk factors associated with mortality in a patient with tuberculous meningitis. These can help to identify a patient who may benefit from more aggressive management. The authors are from Radboud University in The Netherlands and Universitas Padjadjaran in Indonesia.
Patient selection: tuberculous meningitis in Indonesia
Clinical factors associated with one-year mortality:
(1) decreased consciousness
(2) fever (>= 38°C)
(3) focal neurological signs
(4) HIV infection
(5) older age
Glasgow Coma Scale
1-Year Survival
15
78%
14
65%
12 or 13
55%
9 to 11
43%
<= 8
8%
Factors associated with mortality in patients not infected with HIV:
(1) higher CSF neutrophil count (hazard ratio 1.1 per 10% increase; >= 20%)
(2) low CSF to blood glucose ratio (hazard ratio 1.16 per 0.10 decrease; < 0.15))
(3) culture positivity (hazard ratio 1.37)
(4) neutrophilia in peripheral blood (hazard ratio 1.06 per 10^9 increase; >= 11 * 10^9/L))
To read more or access our algorithms and calculators, please log in or register.
