Study of Risk Factors Associated with Bad Outcome among Pediatric Patients with Tubercular Bacterial Meningitis.

Abstract

Introduction: The study aimed to evaluate the risk factors linked to poor outcomes in pediatric patients diagnosed with tubercular bacterial meningitis (TBM).

Methods: A retrospective cohort study was conducted at King George's Medical University in India, focusing on children diagnosed with TBM (n = 514) over a 5-year period from 2019 to 2023. The study evaluates various aspects of TBM in this population, including clinical presentation, diagnostic methods, and outcomes. Statistical analyses for the study were conducted using SPSS version 16.0 (SPSS, Chicago, IL, USA).

Results: Out of a total of 514 patients with TBM, 98 (19.1%) patients experienced a poor outcome. Multivariate analysis identified several factors associated with a poor outcome: age over 5 years (B = 0.829, P = 0.002, odds ratio [OR] = 2.291, 95% confidence interval [CI]: 1.344-3.904), altered consciousness (B = 1.040, P < 0.001, OR = 2.829, 95% CI: 1.686-4.747), a cerebrospinal fluid (CSF)-to-plasma glucose ratio <50% (B = -0.892, P = 0.001, OR = 0.410, 95% CI: 0.244-0.688), hydrocephalus (B = 1.050, P = 0.003, OR = 2.857, 95% CI: 1.417-5.760), and lack of Bacille Calmette-Guerin (BCG) immunization (B = 1.291, P < 0.001, OR = 3.638, 95% CI: 2.150-6.156).

Conclusion: The study identified key risk factors for poor outcomes in childhood TBM, including age over 5 years, high CSF protein levels, coma, hydrocephalus, and inadequate BCG immunization. These factors underline the severity of childhood TBM as a public health issue and emphasize the need for timely initiation of antituberculosis therapy.