Implications of VP-Shunt, Sodium Level, Glucose Level Ratio and Neurologic Deficit as Clinical Outcome Prognostic Factor in Adult Meningitis Tuberculosis with Acute Hydrocephalus in Dr. Hasan Sadikin General Hospital

Abstract

Introduction: Meningitis is the most severe and dangerous complication of tuberculosis, and can be fatal if not treated adequately. Acute hydrocephalus is often accompanied by tuberculous meningitis. This study aims to assess the prognostic factors in adult patients with tuberculous meningitis accompanied by hydrocephalus. Methods: The study was conducted retrospectively by collecting data from the medical records of patients with TB meningitis. Patient data were collected and analyzed using multiple logistic regression to obtain significant prognostic factors. Result: Fifty-four patients had Grade II TB meningitis and 42 patients had Grade III TB meningitis. In this study, it was found that patients with Grade III had higher mortality than patients with Grade II, especially within 30 days of treatment (HR = 3.73 (2.02-6.89), p<0.0001). In patients with Grade II, low sodium levels increased the risk of mortality compared to near-normal sodium levels (HR = 4.22 (1.44-12.43), p = 0.0088). In patients with Grade III, VP-shunt action reduced the risk of mortality (HR = 0.23 (0.09-0.55), p = 0.0011). Meanwhile, the ratio of glucose levels and neurological deficits was not significant as a prognostic factor (p>0.05). Conclusions: Patients with grade III TB meningitis generally have a high risk of mortality and require VP-Shunt intervention to increase life expectancy. In patients with grade II tuberculous meningitis, sodium level plays a role in determining the prognosis.