Three-year mortality in cryptococcal meningitis: Hyperglycemia predict unfavorable outcome

Area of Science:

• Infectious Diseases
• Neurology
• Epidemiology

Background:

• Cryptococcal meningitis (CM) presents a grave prognosis, with high short-term mortality.
• Long-term survival and prognostic factors for CM remain poorly understood.

Purpose of the Study:

• To investigate the 3-year mortality rate in patients diagnosed with CM.
• To identify and analyze the predictive factors associated with 3-year mortality in CM patients.

Main Methods:

• Retrospective cohort study involving 83 patients with cerebrospinal fluid culture-confirmed CM.
• Data collected at China Medical University Hospital between 2003 and 2016.
• Cox proportional hazard model used for multivariate analysis of prognostic factors.

Main Results:

• The 3-year mortality rate for CM was 54% (45 out of 83 patients).
• Factors associated with 3-year mortality included advanced age, HIV-seronegative status, low Glasgow Coma Scale score, decreased hemoglobin, and hyperglycemia.
• Severe hyperglycemia (serum glucose ≥200 mg/dL) at diagnosis was the sole independent predictor of 3-year mortality after multivariate adjustment.

Conclusions:

• Cryptococcal meningitis carries a significant long-term mortality risk.
• Severe hyperglycemia is a critical, independent predictor of 3-year mortality in CM patients, highlighting the need for glycemic control.