Retrospective study identifies disease severity and host factors as drivers of poor neurological outcomes in tuberculous meningitis, indicating limited benefit from intensified regimens.
Key Points
To identify independent risk factors associated with poor neurological prognosis at discharge in patients with tuberculous meningitis and evaluate the therapeutic impact of intensified treatment regimens.
Retrospectively analyzed 518 patients with tuberculous meningitis from two medical centers in China.
Used LASSO and multivariable logistic regression to identify independent prognostic factors, alongside 1:1 propensity score matching to adjust for intensified treatment exposure.
Poor neurological outcomes occurred in 23.75% (123/518) of patients at discharge.
Decreased muscle strength, MRC stage II/III (stage III in 30.08% vs. 8.35%, p < 0.001), albumin < 30 g/L, and hydrocephalus were independent risk factors for poor neurological recovery.
Intensified therapy with linezolid or fluoroquinolones showed no statistically significant association with improved neurological outcomes after propensity score matching.