Risk factors for poor outcome in childhood tuberculous meningitis

Tuberculous meningitis (TBM) remains a serious disease for children and its risk factors of poor outcome remain unclear. Therefore, a retrospective study was conducted aiming to investigate the risk factors associated with poor outcome of childhood TBM. Between January 2006 and December 2019, consecutive children patients (<= 15 years old) who had a diagnosis of TBM were included for the analysis. The demographic, clinical, laboratory, and radiographic data were collected from the electronic medical records retrospectively. Poor outcome was defined as death or transfer to a higher-level hospital. Patients were then divided into good and poor outcome groups. Subsequently, risk factors for poor outcome were estimated using univariate and multivariate logistic regression analysis. A total of 149 children with TBM was enrolled, twenty-two patients suffered poor outcome, including 16 transfers to a higher-level hospital and 6 deaths, and the remaining 127 patients were classified as good outcome group. Further multivariate analysis revealed that coma (age- and sex-adjusted OR=6.425, 95% CI: 1.743, 23.676; P<0.01) and cerebrospinal fluid (CSF) protein (>1188.3 mg/L; age- and sex-adjusted OR=4.680, 95% CI: 1.469, 14.902; P<0.01) were associated with the poor outcome of childhood TBM. Childhood TBM remains to have a high mortality rate in China. High CSF protein and coma were identified as risk factors for poor outcome of childhood TBM. Hence, more attention is required to be paid to suspected patients with such characteristics, thus facilitating access to optimum treatment.

Automated summary

Childhood tuberculous meningitis (TBM) still remains a serious disease with high mortality rates in China. Risk factors such as high cerebrospinal fluid protein levels and coma were identified to be associated with poor outcomes of childhood TBM. More attention should be given to suspected patients with these characteristics to ensure they receive optimal treatment.