ArticleCritical care (London, England)2018
Functional outcomes in adults with tuberculous meningitis admitted to the ICU: a multicenter cohort study.
Article in Critical care (London, England), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 3 of them syntheses that pooled it.
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Who cites it
22 citing papers in PubMed, 3 syntheses or guidelines pooled it, 40 citations in OpenAlex.
- Adjunctive linezolid in patients with tuberculous meningitis for the prevention of mortality or neurologic disability: a meta-analysis of randomized controlled trials.BMC infectious diseases · 2026Pooled it
- Microbiological diagnosis and mortality of tuberculosis meningitis: Systematic review and meta-analysis.PloS one · 2023Pooled it
- Global Frequency and Clinical Features of Stroke in Patients With Tuberculous Meningitis: A Systematic Review.JAMA network open · 2022Pooled it
- Evaluating Desirability of Outcome Ranking (DOOR) and Win Ratio for Hierarchical Composite Endpoints in Cryptococcal Meningitis Trials.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026Article
- Admission C-reactive protein-to-albumin ratio and serum creatinine in relation to in-hospital mortality in non-HIV tuberculous meningitis: a retrospective cohort study.Frontiers in medicine · 2026Article
- Standardized Infliximab Regimen to Treat Severe Central Nervous System Tuberculosis: A Case Series of 18 Patients.Open forum infectious diseases · 2025Article
- Neuroimaging for prognosis of central nervous system infections: a systematic review and meta-analysis.Annals of intensive care · 2025Article
- A retrospective study on unfavorable 28-day neurological outcomes of stage II TB meningitis.Scientific reports · 2025Article
- Influence of HIV co-infection on clinical presentation and disease outcome in hospitalized adults with tuberculous meningitis in Brazil: a nationwide observational study.Frontiers in public health · 2025Observational
- Comprehensive assessment and progression of health status during neurorehabilitation in survivors of critical illness: a prospective cohort study.Annals of intensive care · 2024Article
- Analysis of risk factors for long-term mortality in patients with stage II and III tuberculous meningitis.BMC infectious diseases · 2024Article
- Reduced health-related quality of life, fatigue, anxiety and depression affect COVID-19 patients in the long-term after chronic critical illness.Scientific reports · 2024Article
- Epidemiology, clinical presentation, and predictors of outcome in nontuberculous mycobacterial central nervous system infection: a systematic review.Tropical medicine and health · 2023Review
- Intraspinal and Intracranial Neurotuberculosis, Clinical and Imaging Characteristics and Outcomes in Hospitalized Patients: A Cohort Study (2000-2022).Journal of clinical medicine · 2023Article
- Critical COVID-19 disease: Clinical course and rehabilitation of neurological deficits.Frontiers in neurology · 2022Article
- Normal cerebrospinal fluid protein and associated clinical characteristics in children with tuberculous meningitis.Annals of medicine · 2021Article
- Identifying risks for severity of neurological symptoms in Hungarian West Nile virus patients.BMC infectious diseases · 2021Article
- Inclusion of Mechanical Ventilation in Severity Staging of Tuberculous Meningitis Improves Outcome Prediction.The American journal of tropical medicine and hygiene · 2020Article
- Critical care management of infectious meningitis and encephalitis.Intensive care medicine · 2020Article
- Management of HIV-infected patients in the intensive care unit.Intensive care medicine · 2020Review
Corrections and comments
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Authors and funding
23 authors at 6 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTuberculous meningitis (TBM) is a devastating infection in tuberculosis endemic areas with limited access to intensive care. Functional outcomes of severe adult TBM patients admitted to the ICU in nonendemic areas are not known.
methodsWe conducted a retrospective multicenter cohort study (2004-2016) of consecutive TBM patients admitted to 12 ICUs in the Paris area, France. Clinical, biological, and brain magnetic resonance imaging (MRI) findings at admission associated with a poor functional outcome (i.e., a score of 3-6 on the modified Rankin scale (mRS) at 90 days) were identified by logistic regression. Factors associated with 1-year mortality were investigated by Cox proportional hazards modeling.
resultsWe studied 90 patients, of whom 61 (68%) had a score on the Glasgow Coma Scale ≤ 10 at presentation and 63 (70%) required invasive mechanical ventilation. Brain MRI revealed infarction and hydrocephalus in 38/75 (51%) and 25/75 (33%) cases, respectively. A poor functional outcome was observed in 55 (61%) patients and was independently associated with older age (adjusted odds ratio (aOR) 1.03, 95% CI 1.0-1.07), cerebrospinal fluid protein level ≥ 2 g/L (aOR 5.31, 95% CI 1.67-16.85), and hydrocephalus on brain MRI (aOR 17.2, 95% CI 2.57-115.14). By contrast, adjunctive steroids were protective (aOR 0.13, 95% CI 0.03-0.56). The multivariable adjusted hazard ratio of adjunctive steroids for 1-year mortality (47%, 95% CI 37%-59%) was 0.23 (95% CI 0.11-0.44). Among survivors at 1 year, functional independence (mRS of 0-2) was observed in 27/37 (73%, 95% CI 59%-87%) cases.
conclusionsA poor functional outcome in adult TBM patients admitted to the ICU in a nonendemic area is observed in 60% of cases and is independently associated with elevated cerebrospinal fluid protein level and hydrocephalus. Our data also suggest a protective effect of adjunctive steroids, with reduced disability and mortality, irrespective of immune status and severity of disease at presentation. One-year follow-up revealed functional independence in most survivors.
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