Evaluation of Predictors of Outcome in Patients with Tubercular Meningitis

Tubercular Meningitis (TBM) is a common Central Nervous System (CNS) infection in India and is a serious public health issue that results in significant morbidity and mortality. As per the Index TB Guidelines, TBM constitutes 1% of all cases of TB and has been associated with a poor neurological outcome. This study focused on the various outcome predictors as well as the credibility of the MASH-P scoring system in the prediction of 6-month mortality and possible outcomes in patients with tubercular meningitis. Early prognostication can be beneficial in changing the course of the disease itself. A prospective observational study was done for a period of one and a half years. All medical units of the Post Graduate Institute of Medical Education and Research, Chandigarh are included. All tubercular meningitis patients admitted in medical wards and sub-specialties (Emergency, Internal Medicine, Intensive care) as per the Lancet consensus criteria will be enrolled in the present study after obtaining informed consent. A total of N=50 individuals were included in our study, average age in our group was 33.18 ± 14.05 years, and the gender ratio was 1.7:1 (F:M). The majority (74%) of patients were classified under stage 3 Tuberculous Meningitis (TBM). The mortality rate within the study cohort was 46%, predominantly observed among those with stage 3 TBM. The majority (74%) of patients were classified under stage 3 Tuberculous Meningitis (TBM). The mortality rate within the study cohort was 46%, predominantly observed among those with stage 3 TBM. Regarding clinical parameters, symptoms such as blurred vision, loss of appetite, and motor deficit at the initial presentation exhibited a noteworthy correlation with mortality. Additionally, the presence of papilledema, TBM severity, and the occurrence of hydrocephalus, infarct, and tuberculoma on MRI were linked to mortality. Moreover, MASH-P scores demonstrated a correlation with mortality. These associations were determined on univariate analysis. However, in the multivariate regression analysis, none of the parameters demonstrated statistical significance.