Abstract:

Objective To explore clinical features and influencing factors of prognosis in children with tuberculosis meningitis (TBM). Methods According to the diagnostic criteria, 222 TBM children from the Children’s Hospital affiliated to Chongqing Medical University from January 2015 to January 2019 were included. Univariate analysis and multivariate logistic regression analysis were used to evaluate the clinical indicators and influencing factors of prognosis in TBM children. Results Of the 222 cases, 129 (58.11%) had good prognosis, while 93 had bad prognosis, of whom 7 died; 117 (52.70%) were boys, 107 (48.20%) aged <5 years with the median of 6 years; 108 (48.65%) cases had a history of close contact with TB patients, duration of the diagnosis were over 21 days in 110 cases (49.55%) and 137 (61.71%) cases suffered malnutrition;in 205 cases (92.34%), tuberculosis lesions were found in 2 or more parts or organs, and pulmonary tuberculosis were the most common complication (n=200, 90.01%); 144 cases (64.87%) were at stage Ⅱ and stage Ⅲ TBM (according to GCS score). By multivariate logistic regression analysis, it was found that high cerebrospinal fluid (CSF) glucose and chloride were protective factor of the prognosis of TBM children (OR (95%CI)=0.444 (0.257-0.769);OR (95%CI)=0.914 (0.854-0.980)),the higher the CSF glucose and chloride, the better the prognosis. High incidence rates of consciousness disturbance, personality change,hydrocephalus and obstructive hydrocephalus were the risk factors of prognosis (OR (95%CI)=6.969 (2.283-21.277);OR (95%CI)=2.531 (1.105-5.796);OR (95%CI)=3.429 (1.546-7.604);OR (95%CI)=10.233 (1.059-98.886)). Conclusion Both the poor prognosis and mortality were high in TBM children. The detection of history of close contact with TB patients and tuberculosis in some other organs would help to diagnosis at early stage. Improvement of malnutrition and decreasement of cerebral effusion were good for prognosis.

Key words: Tuberculosis, meningeal, Children, Disease characteristics, Prognosis, Factor analysis, statistical