Outcomes of central nervous system tuberculosis in Saudi Arabia: a multi-center study.

IF 1.7 4区 医学 Q3 CLINICAL NEUROLOGY
Neurological Research Pub Date : 2024-09-01 Epub Date: 2024-06-10 DOI:10.1080/01616412.2024.2359262
Fayez Dhafer Alshehri, Fahad Mahmood Okal, Salem K Baeshen, Zeyad G Alharbi, Osama Khojah, Waseem K Alhawsawi, Saeed Alamoudi, Ammar Bahati, Ahmed I Lary
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引用次数: 0

Abstract

Objectives: Central nervous system tuberculosis (TB) (CNS-TB) can occur in several forms, including intracranial tuberculoma, tuberculous brain abscess, TB meningitis (TBM), and spinal TB. Early treatment can save lives and prevent severe neurological complications. This study aimed to describe the characteristics and post-treatment outcomes of patients with CNS-TB and identify factors associated with poor outcomes. To the best of our knowledge, this is the largest CNS-TB study till date published in Saudi Arabia.

Methods: This retrospective cohort study included all patients diagnosed with CNS-TB in three tertiary centers in Saudi Arabia (King Abdulaziz Medical City in Jeddah, King Abdulaziz Medical City in Riyadh, and Al-Noor Specialist Hospital in Makkah) between 2009 and 2019. Data of patients' demographics, co-morbidities, presenting symptoms, type of CNS-TB, medical and surgical treatments, and outcome after completion of treatment were obtained from medical records. Treatment outcomes were categorized using the modified Rankin Scale for neurological disability.

Results: A total of 140 participants were included in this study from 2009 to 2019. Good outcomes were achieved in approximately 65% of cases, whereas 35% had poor outcomes based on the modified Rankin Scale. Glasgow Coma Scale score ≤10 at presentation and TBM/tuberculoma were significantly associated with poor outcomes. Moreover, the use of corticosteroids, more than three anti-TB medications, and surgical interventions were not significantly associated with good or poor outcomes.

Discussion: CNS-TB is associated with a high burden of long-term neurological morbidity. Early detection and treatment are crucial to prevent serious complications and decrease morbidity and mortality.

沙特阿拉伯中枢神经系统结核病的治疗结果:一项多中心研究。
目的:中枢神经系统结核(CNS-TB)有多种发病形式,包括颅内结核瘤、结核性脑脓肿、结核性脑膜炎(TBM)和脊髓结核。早期治疗可挽救生命并预防严重的神经系统并发症。本研究旨在描述中枢神经系统结核患者的特征和治疗后的预后,并找出与不良预后相关的因素。据我们所知,这是迄今为止在沙特阿拉伯发表的最大规模的中枢神经系统结核研究:这项回顾性队列研究纳入了 2009 年至 2019 年期间在沙特阿拉伯三个三级医疗中心(吉达的阿卜杜勒阿齐兹国王医疗城、利雅得的阿卜杜勒阿齐兹国王医疗城和麦加的 Al-Noor 专科医院)确诊的所有中枢神经系统结核患者。患者的人口统计学、合并疾病、主要症状、中枢神经系统结核类型、内科和外科治疗以及治疗结束后的结果等数据均来自医疗记录。治疗结果采用改良兰金量表对神经系统残疾进行分类:从 2009 年到 2019 年,共有 140 名参与者参与了这项研究。根据改良的兰金量表,约 65% 的病例取得了良好的治疗效果,而 35% 的病例治疗效果不佳。发病时格拉斯哥昏迷量表评分≤10分和TBM/肺结核瘤与不良预后显著相关。此外,皮质类固醇的使用、三种以上抗结核药物的使用以及手术干预与预后好坏无明显关系:讨论:中枢神经系统结核与长期神经系统发病率的高负担相关。早期发现和治疗对于预防严重并发症、降低发病率和死亡率至关重要。
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来源期刊
Neurological Research
Neurological Research 医学-临床神经学
CiteScore
3.60
自引率
0.00%
发文量
116
审稿时长
5.3 months
期刊介绍: Neurological Research is an international, peer-reviewed journal for reporting both basic and clinical research in the fields of neurosurgery, neurology, neuroengineering and neurosciences. It provides a medium for those who recognize the wider implications of their work and who wish to be informed of the relevant experience of others in related and more distant fields. The scope of the journal includes: •Stem cell applications •Molecular neuroscience •Neuropharmacology •Neuroradiology •Neurochemistry •Biomathematical models •Endovascular neurosurgery •Innovation in neurosurgery.
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