Open AccessThree-year mortality in cryptococcal meningitis: Hyperglycemia predict unfavorable outcome
Author(s) -
Sheng-Ta Tsai,
Fu-Yu Lin,
Pei-Shan Chen,
HsiuYin Chiang,
ChinChi Kuo
Publication year - 2021
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0251749
Subject(s) - glasgow coma scale , medicine , retrospective cohort study , proportional hazards model , cryptococcal meningitis , mortality rate , hazard ratio , survival analysis , meningitis , multivariate analysis , pediatrics , surgery , human immunodeficiency virus (hiv) , immunology , viral disease , confidence interval
Existing evidence revealed grave prognosis for cryptococcal meningitis (CM), particularly its short-term mortality. However, its long-term survival and prognostic factors remained unknown. This study investigated 3-year mortality and analyzed its predictive factors in patients with CM. This retrospective cohort study with 83 cerebrospinal fluid culture-confirmed CM patients was conducted at China Medical University Hospital from 2003 to 2016. The 3-year mortality rate in patients with CM was 54% (45 deaths among 83 patients). Advanced age, human immunodeficiency virus (HIV) seronegative state, low Glasgow Coma Scale score on admission, decreased hemoglobin and hyperglycemia on diagnosis were associated with 3-year mortality. After multivariate adjustment in the Cox proportional hazard model, only severe hyperglycemia (serum glucose ≥200 mg/dL) on diagnosis could predict 3-year mortality.