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Prognostic factors of adult tuberculous meningitis in intensive care unit: a single-center retrospective study in East China
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 retro...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8353730/ https://www.ncbi.nlm.nih.gov/pubmed/34376174 http://dx.doi.org/10.1186/s12883-021-02340-3 |
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author | Feng, Baobao Fei, Xiao Sun, Ying Zhang, Xingguo Shang, Deya Zhou, Yi Sheng, Meiyan Xu, Jiarui Zhang, Wei Ren, Wanhua |
author_facet | Feng, Baobao Fei, Xiao Sun, Ying Zhang, Xingguo Shang, Deya Zhou, Yi Sheng, Meiyan Xu, Jiarui Zhang, Wei Ren, Wanhua |
author_sort | Feng, Baobao |
collection | PubMed |
description | 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. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12883-021-02340-3. |
format | Online Article Text |
id | pubmed-8353730 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-83537302021-08-10 Prognostic factors of adult tuberculous meningitis in intensive care unit: a single-center retrospective study in East China Feng, Baobao Fei, Xiao Sun, Ying Zhang, Xingguo Shang, Deya Zhou, Yi Sheng, Meiyan Xu, Jiarui Zhang, Wei Ren, Wanhua BMC Neurol Research Article 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. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12883-021-02340-3. BioMed Central 2021-08-10 /pmc/articles/PMC8353730/ /pubmed/34376174 http://dx.doi.org/10.1186/s12883-021-02340-3 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Article Feng, Baobao Fei, Xiao Sun, Ying Zhang, Xingguo Shang, Deya Zhou, Yi Sheng, Meiyan Xu, Jiarui Zhang, Wei Ren, Wanhua Prognostic factors of adult tuberculous meningitis in intensive care unit: a single-center retrospective study in East China |
title | Prognostic factors of adult tuberculous meningitis in intensive care unit: a single-center retrospective study in East China |
title_full | Prognostic factors of adult tuberculous meningitis in intensive care unit: a single-center retrospective study in East China |
title_fullStr | Prognostic factors of adult tuberculous meningitis in intensive care unit: a single-center retrospective study in East China |
title_full_unstemmed | Prognostic factors of adult tuberculous meningitis in intensive care unit: a single-center retrospective study in East China |
title_short | Prognostic factors of adult tuberculous meningitis in intensive care unit: a single-center retrospective study in East China |
title_sort | prognostic factors of adult tuberculous meningitis in intensive care unit: a single-center retrospective study in east china |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8353730/ https://www.ncbi.nlm.nih.gov/pubmed/34376174 http://dx.doi.org/10.1186/s12883-021-02340-3 |
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