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Brain Abscess l: Introduction01:26

Brain Abscess l: Introduction

A brain abscess is a focal, intracerebral infection characterized by a localized collection of pus within the brain parenchyma, resulting from microbial invasion and the body’s inflammatory response. It progresses through stages: early and late cerebritis, followed by early and late capsule formation, reflecting tissue destruction, immune response, and eventual encapsulation.Etiology and PathogenesisCausative organisms vary with source and host factors, often involving polymicrobial infections,...

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Dynamic nomogram for predicting long-term survival in patients with brain abscess.

Thara Tunthanathip1, Rakkrit Duangsoithong2, Waranyu Kittirojkasem3

  • 1Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Prince of Songkla University, Songkhla, 90110, Thailand. tsus4@hotmail.com.

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Summary

This study identifies key predictors of long-term survival in brain abscess (BA) patients and develops a validated dynamic nomogram for personalized prognostication, aiding clinical decisions.

Keywords:
Brain abscessInfectionLong-term survivalNomogramPrognosisSurvival

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Area of Science:

  • Neurology
  • Infectious Diseases
  • Medical Statistics

Background:

  • Brain abscess (BA) presents significant mortality and morbidity risks.
  • Limited research exists on predicting long-term survival in BA patients.
  • Accurate prognostication is crucial for effective clinical management.

Purpose of the Study:

  • To identify independent predictors of long-term survival in brain abscess patients.
  • To develop and validate a dynamic nomogram for individualized prognostication of BA survival.
  • To provide a tool for enhanced clinical decision-making in BA management.

Main Methods:

  • Retrospective cohort study of 205 brain abscess patients.
  • Analysis of demographic, clinical, laboratory, and imaging data.
  • Cox regression for prognostic factor identification; nomogram developed and validated using C-index, calibration plots, and ROC curves.

Main Results:

  • Identified age, Karnofsky performance status, hemoculture results, coagulopathy, neutrophil-to-lymphocyte ratio, bandemia, and occipital BA as predictors.
  • Developed a dynamic nomogram with strong predictive performance (C-index 0.855 apparent, 0.701 validation).
  • Validation confirmed the nomogram's reliability for predicting long-term survival.

Conclusions:

  • A validated dynamic nomogram for predicting long-term survival in brain abscess patients has been developed.
  • This interactive tool facilitates individualized risk assessment and clinical decision-making.
  • Further external validation and refinement are recommended for broader applicability.