Sofiati Dian, Edwin Ardiansyah, Lidya Chaidir, Arjan van Laarhoven, Rovina Ruslami, Bachti Alisjahbana, Ahmad Rizal Ganiem, Reinout van Crevel
{"title":"结核性脑膜炎低钠血症的临床意义：印度尼西亚的一项前瞻性队列研究。","authors":"Sofiati Dian, Edwin Ardiansyah, Lidya Chaidir, Arjan van Laarhoven, Rovina Ruslami, Bachti Alisjahbana, Ahmad Rizal Ganiem, Reinout van Crevel","doi":"10.1093/ofid/ofae673","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Hyponatremia is common in tuberculous meningitis (TBM), but its impact on disease severity and outcomes is unclear.</p><p><strong>Methods: </strong>In a cohort of 864 adult patients with TBM in Indonesia, we assessed the prevalence and prognostic significance of hyponatremia, classified as moderate (120-130 mEq/L) or severe (<120 mEq/L). Patients received standard antituberculous therapy and corticosteroids and were followed for 1-year mortality.</p><p><strong>Results: </strong>Hyponatremia occured in 86.8% of patients, with 26% classified as severe. Severe hyponatremia associated with male, younger age, a lower Glasgow Coma Scale (GCS), and markers of more severe disease (<i>P</i> < .05). One-year mortality was 46.5% and associated with older age, HIV infection, lower GCS, markers of neurologic severity, fever, and thrombocytosis. Severe hyponatremia predicted mortality in univariate analysis showed no impact in HIV-positive patients.</p><p><strong>Conclusions: </strong>Hyponatremia reflects disease severity in TBM but does not independently predict mortality, suggesting limited benefit from agressive correction.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"11 12","pages":"ofae673"},"PeriodicalIF":3.8000,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11630896/pdf/","citationCount":"0","resultStr":"{\"title\":\"Clinical Significance of Hyponatremia in Tuberculous Meningitis: A Prospective Cohort in Indonesia.\",\"authors\":\"Sofiati Dian, Edwin Ardiansyah, Lidya Chaidir, Arjan van Laarhoven, Rovina Ruslami, Bachti Alisjahbana, Ahmad Rizal Ganiem, Reinout van Crevel\",\"doi\":\"10.1093/ofid/ofae673\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Hyponatremia is common in tuberculous meningitis (TBM), but its impact on disease severity and outcomes is unclear.</p><p><strong>Methods: </strong>In a cohort of 864 adult patients with TBM in Indonesia, we assessed the prevalence and prognostic significance of hyponatremia, classified as moderate (120-130 mEq/L) or severe (<120 mEq/L). Patients received standard antituberculous therapy and corticosteroids and were followed for 1-year mortality.</p><p><strong>Results: </strong>Hyponatremia occured in 86.8% of patients, with 26% classified as severe. Severe hyponatremia associated with male, younger age, a lower Glasgow Coma Scale (GCS), and markers of more severe disease (<i>P</i> < .05). One-year mortality was 46.5% and associated with older age, HIV infection, lower GCS, markers of neurologic severity, fever, and thrombocytosis. Severe hyponatremia predicted mortality in univariate analysis showed no impact in HIV-positive patients.</p><p><strong>Conclusions: </strong>Hyponatremia reflects disease severity in TBM but does not independently predict mortality, suggesting limited benefit from agressive correction.</p>\",\"PeriodicalId\":19517,\"journal\":{\"name\":\"Open Forum Infectious Diseases\",\"volume\":\"11 12\",\"pages\":\"ofae673\"},\"PeriodicalIF\":3.8000,\"publicationDate\":\"2024-11-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11630896/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Open Forum Infectious Diseases\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1093/ofid/ofae673\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/12/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"IMMUNOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Open Forum Infectious Diseases","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/ofid/ofae673","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/12/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"IMMUNOLOGY","Score":null,"Total":0}
Clinical Significance of Hyponatremia in Tuberculous Meningitis: A Prospective Cohort in Indonesia.
Background: Hyponatremia is common in tuberculous meningitis (TBM), but its impact on disease severity and outcomes is unclear.
Methods: In a cohort of 864 adult patients with TBM in Indonesia, we assessed the prevalence and prognostic significance of hyponatremia, classified as moderate (120-130 mEq/L) or severe (<120 mEq/L). Patients received standard antituberculous therapy and corticosteroids and were followed for 1-year mortality.
Results: Hyponatremia occured in 86.8% of patients, with 26% classified as severe. Severe hyponatremia associated with male, younger age, a lower Glasgow Coma Scale (GCS), and markers of more severe disease (P < .05). One-year mortality was 46.5% and associated with older age, HIV infection, lower GCS, markers of neurologic severity, fever, and thrombocytosis. Severe hyponatremia predicted mortality in univariate analysis showed no impact in HIV-positive patients.
Conclusions: Hyponatremia reflects disease severity in TBM but does not independently predict mortality, suggesting limited benefit from agressive correction.
期刊介绍：
Open Forum Infectious Diseases provides a global forum for the publication of clinical, translational, and basic research findings in a fully open access, online journal environment. The journal reflects the broad diversity of the field of infectious diseases, and focuses on the intersection of biomedical science and clinical practice, with a particular emphasis on knowledge that holds the potential to improve patient care in populations around the world. Fully peer-reviewed, OFID supports the international community of infectious diseases experts by providing a venue for articles that further the understanding of all aspects of infectious diseases.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
