Clinical factors predictive of functional outcomes in tuberculous meningitis

Reasons for poor outcomes in tuberculous meningitis (TBM), which accounts for 2.3% of all tuberculosis cases in Thailand, are still being debated. Here, we studied factors associated with functional outcomes of TBM patients in Thailand where tuberculosis is endemic. We retrospectively reviewed all patients diagnosed with TBM at Srinagarind Hospital, Khon Kaen University, Thailand, between January 2002 and December 2008. Twenty-five patients met the study criteria; 11 of these (44.0%) had good or distinctly improved status at discharge. Duration of TBM symptoms for more than 14 days was significantly negatively associated with good discharge status (aOR 0.068; 95% CI: 0.005-0.945). Long-term functional status, assessed using the modified Rankin scale, was also significantly higher in those who had good discharge status compared with those who had poor discharge status (p=0.005). In conclusion, shorter duration of TBM symptoms was correlated with good outcomes with respect to both short- and long-term functional status.