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Prognostic clinical variables in childhood tuberculous meningitis: an experience from Mumbai, India.
Neurol India ; 2005 Jun; 53(2): 191-5; discussion 195-6
Artigo em Inglês | IMSEAR | ID: sea-121632
ABSTRACT

BACKGROUND:

In India, tuberculous meningitis (TBM) is still a major cause of neurological disabilities and death.

AIM:

To identify the clinical variables which predict the outcome in childhood TBM.

SETTING:

Tertiary teaching hospital.

DESIGN:

Prospective observational study. MATERIALS AND

METHODS:

Thirty-six clinical variables were analyzed in 123 consecutive children with TBM admitted between May 2000 and August 2003. The outcome was assessed in terms of survival or death. Survival meant that the patient was discharged from hospital having made a complete recovery, or with disability.

RESULTS:

Twenty-five (20%) children recovered completely, 70 (57%) survived with disability, and 28 (23%) died. Employing univariate analysis nine variables correlated with survival with disability

outcome:

presence of tonic motor posturing, cranial nerve palsy, focal neurological deficit, hypertonia, moderate to severe hydrocephalus, cerebral infarction on cranial CT, and requiring shunt surgery, and absence of extracranial tuberculosis and no antituberculous-related hepatotoxicity; two variables correlated with fatal

outcome:

presence of deep coma (Glasgow coma scale score P = 0.012, d.f. = 1, OR 0.12, 95% CI 0.02-0.62) correlated with survival with disability outcome, and presence of deep coma (P = 0.030, d.f. = 1, OR 0.35, 95% CI 0.14-0.90) with fatal outcome.

CONCLUSION:

In children with TBM, the presence of hypertonia at admission is an independent predictor of neurological sequelae in survivors, and deep coma is an independent predictor of mortality.
Assuntos
Texto completo: DisponíveL Índice: IMSEAR (Sudeste Asiático) Assunto principal: Prognóstico / Feminino / Humanos / Masculino / Criança / Pré-Escolar / Estado Nutricional / Valor Preditivo dos Testes / Resultado do Tratamento / Índia Tipo de estudo: Estudo observacional / Estudo prognóstico País/Região como assunto: Ásia Idioma: Inglês Revista: Neurol India Ano de publicação: 2005 Tipo de documento: Artigo

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Texto completo: DisponíveL Índice: IMSEAR (Sudeste Asiático) Assunto principal: Prognóstico / Feminino / Humanos / Masculino / Criança / Pré-Escolar / Estado Nutricional / Valor Preditivo dos Testes / Resultado do Tratamento / Índia Tipo de estudo: Estudo observacional / Estudo prognóstico País/Região como assunto: Ásia Idioma: Inglês Revista: Neurol India Ano de publicação: 2005 Tipo de documento: Artigo