A retrospective study on unfavorable 28-day neurological outcomes of stage II TB meningitis

Tuberculous meningitis (TBM) is often associated with adverse neurological outcomes, however, there is a lack of relevant research. The aim of this study is to explore the risk factors that affect the poor prognosis of 28-day neurological function in patients with stage II TBM. A retrospective analysis was conducted on the clinical data of patients with stage II TBM who visited our hospital from January 1st, 2018 to August 1st, 2019 based on the staging criteria of the Medical Research Council. The neurological function prognosis after 28 days of follow-up was determined to establish independent risk factors. A total of 138 patients (82 male and 56 female) were included, with an average onset age of 37.01 ± 17.30 years. Forty patients had poor prognosis (Modified Rankin Scale [MRS] score, 3-6 points), while 98 patients had a good prognosis (MRS score, 0-2 points). Multivariate logistic regression analysis showed that peripheral nerve dysfunction (odds ratio [OR], 6.315; 95% confidence interval [CI] 2.319-17.196; p < 0.001), Quick Sequential Organ Failure Assessment (QSOFA) score (OR 7.343; 95% CI 2.984-18.066; p < 0.001), and hydrocephalus (OR 2.685; 95% CI 1.020-7.068; p = 0.045) were independent risk factors. The area under the curve for predicting the 28-day neurological prognosis of patients with stage II TBM using the QSOFA score was 0.766 (95% CI 0.680-0.853; p < 0.001). Peripheral nerve dysfunction, QSOFA score, and hydrocephalus are independent risk factors for 28-day neurological dysfunction in patients with stage II TBM. The QSOFA score had good predictive ability of the prognosis in terms of 28-day neurological function of patients with stage II TBM.