Profiles of primary brain abscesses and their impact on survival: An international ID-IRI study.
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Sahin Meyha, Mert Ali, Emecen Ahmet Naci, Strunjas Natalija Planinc, Fasanekova Lenka, Batirel Ayse, Darazam Ilad Alavi, Ansari Shabboo, Firouzjaei Ghazaleh Golchoub, Stebel Roman, Tigen Elif Tukenmez, Sengel Buket Erturk, Dzupova Olga, Belitova Maya, Abid Maha, Demirbaş Nazife Duygu, Erol Serpil, Kul Halil, Pekok Abdullah Umut, Ulusoy Tülay Ünver, Alay Handan, Amiri Zahra Mohtasham, Cascio Antonio, Karadağ Mehmet Kürşat, Kolovani Entela, Mladenov Nikolay, Ramosaco Ergys, Sipahi Oğuz Reşat, Şanlıdağ Gamze, El-Kholy Amani, Okay Gulay, Pshenichnaya Natalia, Şahinoğlu Mustafa Serhat, Alkan Sevil, Özdemir Mehmet, Rahimi Bilal Ahmad, Karlidag Gulden Eser, Balin Şafak Özer, Liskova Anna, Jouhar Anas, Almajid Fahad, Artur Xhumari, Çelik Mehmet, Khan Asfandiyar, Lanzafame Massimiliano, Marıno Andrea, Şenol Arzu, Oncu Serkan, Uğuz Mustafa, Zajkowska Joanna, Erdem Hakan
Аннотация
METHODS: Data were collected from 39 centers across 16 countries between January 2010 and December 2022, and clinical, radiological, and microbiological findings, along with their impact on mortality, were analyzed.
RESULTS: The patients had a mean ± SD age of 46.8 ± 16.3 years, with a male predominance of 71.6%. Common symptoms included headache (77.9%), fever (54.4%), and focal neurological deficits (53.5%). Gram-positive cocci were the predominant pathogens, with Viridans group streptococci identified as the most frequently isolated organisms. All patients received antimicrobial therapy and 71.6% underwent interventional therapies. The 42-day and 180-day survival rates were 91.9% and 86.1%, respectively. Significant predictors of 42-day mortality included intravenous drug addiction (HR: 6.02, 95% CI: 1.38-26.26), malignancy (HR: 3.61, 95% CI: 1.23-10.58), confusion (HR: 2.65, 95% CI: 1.19-5.88), and unidentified bacteria (HR: 4.68, 95% CI: 1.76-12.43). Significant predictors of 180-day mortality included malignancy (HR: 2.70, 95% CI: 1.07-6.81), confusion (HR: 2.14, 95% CI: 1.11-4.15), temporal lobe involvement (HR: 2.10, 95% CI: 1.08-4.08), and unidentified bacteria (HR: 3.02, 95% CI: 1.49-6.15).
CONCLUSION: The risk of death in PBA extends beyond the infection phase, with different factors influencing the 42-day and 180-day mortality rates. Intravenous drug addiction was associated with early mortality, while temporal lobe involvement was associated with late mortality.