Long-term mortality in patients with tuberculous meningitis: a Danish nationwide cohort study.

Long-term mortality in patients with tuberculous meningitis: a Danish nationwide cohort study.

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BACKGROUND: With high short-term mortality and substantial excess morbidity among survivors, tuberculous meningitis (TBM) is the most severe manifestation of extra-pulmonary tuberculosis (TB).The objective of this study was to assess the long-term mortality and causes of death in a TBM patient population compared to the background population.METHODS: A nationwide cohort study was conducted enrolling patients notified with TBM in Denmark from 1972-2008 and alive one year after TBM diagnosis.Data was extracted from national registries.

From the background population we identified a control cohort of individuals matched on gender and date of birth.Kaplan-Meier Projection Screen survival curves and Cox regression analysis were used to estimate mortality rate ratios (MRR) and analyse causes of death.FINDINGS: A total of 55 TBM patients and 550 individuals from the background population were included in the study.Eighteen patients (32.

7%) and 107 population controls (19.5%) died during the observation period.The overall MRR was 1.79 (95%CI: 1.

09-2.95) for TBM patients compared to the population control cohort.TBM patients in the age group 31-60 years at time of diagnosis had the highest relative risk of death (MRR 2.68; 95%CI 1.

34-5.34).The TBM patients had a higher risk of death due to infectious disease, but not from other causes of death.CONCLUSION: Adult TBM patients have an almost two-fold increased long-term mortality and the excess mortality stems EZEKIEL SPROUTED BURGER BUNS from infectious disease related causes of death.