Comparative analysis of the survival of patients with tuberculous meningitis and pulmonary tuberculosis

Montalvo R.; Díaz-Lazo A.; Rodríguez C.; Castro J.; Suárez M.; Acuña F. · Neurologia Argentina (2022) · DOI: 10.1016/j.neuarg.2021.09.004

Resumen

Introduction: Tuberculous meningitis is the most serious manifestation of the disease by Micobacterium tuberculosis with a high rate of mortality and sequela among survivors. Nonspecific clinical features and limited laboratory tests lead to delay in diagnosis and treatment, thus reducing the survival of patients. Objective: Analyze the survival of patients with tuberculous meningitis (TBM) and compare with other pulmonary tuberculosis at Daniel Alcides Carrión Hospital in Huancayo, Perú. Materials and methods: An observational, analytical, retrospective study of patients with the diagnosis of tuberculosis over 14 years old was carried out at Daniel Alcides Carrión Hospital in Huancayo, from January 2015 to December 2019. Results: Of 1168 patients diagnosed with tuberculosis; 4.7% had tuberculous meningoencephalitis; the average age was 33 years old, 69% were men; the characteristics of the cerebrospinal fluid were mononuclear predominance of pleocytosis, associated with hyper proteinorachie, hypoglycorrhachia, and adenosine deaminase values above 9 U/L. The mortality of TBM was 43%; a prolonged time of illness before going to the hospital (p =.03) and a low Glasgow coma scale score (p =.02) were associated with higher mortality. La survival probability of patients with TBM at 20 days after starting treatment was 23% (p:.01; HR: 4.23; 95% CI: 1.44–12.36) and in patients with pulmonary tuberculosis the probability of survival was 79%. Conclusions: TBM shows poorer survival, so it is essential to improve the capacity for early diagnosis and differentiated treatment.

Instituciones: Universidad Peruana Los Andes; Universidad Nacional del Centro del Perú