Isoniazid dose-related prediction model for patients with tuberculosis meningitis in southwest China

Abstract

Abstract Purpose Tuberculosis meningitis is the most lethal type of tuberculosis, and its prognosis is related to disease severity and early therapeutic intervention. A model was developed to predict the mortality risk of adults with tuberculosis meningitis based on the prognostic factors associated with the disease. Methods Patients were screened for primary tuberculosis meningitis and received a quadruple regimen comprising isoniazid (standard dose 300 mg/day; high dose of 600 mg/day), rifampin, ethambutol, and pyrazinamide. We analyzed the indices and prognosis factors of patients who died from the disease, using 12-month treatment mortality as the primary observation endpoint. Predictors included demographic data, clinical presentation, ancillary tests, treatment changes, isoniazid dose. Least absolute shrinkage and selection operator regression and multi-factor logistic regression were employed for data analysis. Results A total of 119 patients with tuberculosis meningitis were recruited for this study. At the end of December, there were 18 deaths and 101 surviving patients. Sixty-eight influencing factors were screened and five clinical factors were included in the model as potential prognostic factors: older age, presence of nausea, high MRC grade, imaging suggestive of cerebral infarction, and use isoniazid dose of 300 mg/day. The AUC was 0.8316832. The model utilized in this study proved beneficial to predict outcome of patients. Conclusion The final model is suitable for evaluating the risk of death within 12 months in patients with tuberculosis meningitis and helps assess the severity and treatment needs of patients. The isoniazid dose is an important factor affecting the prognosis of these patients.