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Войти в исследования International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2026
Clinical and neuroimaging predictors of outcome and impact of surgical intervention in cryptococcal meningitis: An observational study.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
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Qian Meng-Yi, He Long-Yuan, Lan Ping, Mungur Rajneesh, Pan De-Sheng, Bi Sheng, Zou Wen-Juan, Lou Hai-Yan, Wang Feng
Аннотация
BACKGROUND: This study aimed to identify predictors of outcomes and evaluate the therapeutic impact of surgical intervention in CM patients, with a specific focus on the growing HIV-negative population in East Asia.
METHODS: We conducted a single-center retrospective cohort study. The primary outcome was the 12-month modified Rankin Scale (mRS) score. Multivariable ordinal logistic regression and propensity score matching (PSM) analysis were employed to identify independent predictors of outcome and evaluate the association with surgical intervention.
RESULTS: The cohort comprised 181 patients. The unfavorable outcome rate in HIV-negative group was higher than in the HIV-positive group (19.1% vs 5.0%). Impaired consciousness (OR: 5.51, 95% CI: 2.13-14.26), motor deficits (OR: 3.83, 95% CI: 1.42-10.35), and advanced age (OR: 2.04, 95% CI: 1.43-2.91) showed independent associations with unfavorable outcome. Hydrocephalus and periventricular edema showed trends toward worse outcomes in univariate analyses. After PSM, surgical intervention was associated with lower odds of unfavorable outcomes among patients with hydrocephalus or refractory intracranial hypertension (adjusted Odds Ratio 0.32; P = 0.011). Peak CSF pressure showed limited accuracy for long-term outcomes (AUC = 0.562).
CONCLUSION: Clinical severity markers independently predicted 12-month outcomes, while surgical intervention was associated with improved prognosis in patients with CSF dynamic disorders.
METHODS: We conducted a single-center retrospective cohort study. The primary outcome was the 12-month modified Rankin Scale (mRS) score. Multivariable ordinal logistic regression and propensity score matching (PSM) analysis were employed to identify independent predictors of outcome and evaluate the association with surgical intervention.
RESULTS: The cohort comprised 181 patients. The unfavorable outcome rate in HIV-negative group was higher than in the HIV-positive group (19.1% vs 5.0%). Impaired consciousness (OR: 5.51, 95% CI: 2.13-14.26), motor deficits (OR: 3.83, 95% CI: 1.42-10.35), and advanced age (OR: 2.04, 95% CI: 1.43-2.91) showed independent associations with unfavorable outcome. Hydrocephalus and periventricular edema showed trends toward worse outcomes in univariate analyses. After PSM, surgical intervention was associated with lower odds of unfavorable outcomes among patients with hydrocephalus or refractory intracranial hypertension (adjusted Odds Ratio 0.32; P = 0.011). Peak CSF pressure showed limited accuracy for long-term outcomes (AUC = 0.562).
CONCLUSION: Clinical severity markers independently predicted 12-month outcomes, while surgical intervention was associated with improved prognosis in patients with CSF dynamic disorders.