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All Journal MNJ (Malang Neurology Journal) Medicinus : Jurnal Kedokteran Majalah Kedokteran Neurosains Eduvest - Journal of Universal Studies Neurona Acta Neurologica Indonesia
Vivien Puspitasari, Vivien
Department Of Neurology, Faculty Of Medicine, University Of Pelita Harapan Siloam Hospital Lippo Village
Aerospace Engineering Computer Science & IT Health Professions Medicine & Pharmacology Neuroscience Public Health Social Sciences

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Factors Affecting Progonosis in Tuberculous Meningoencephalitis Puspitasari, Vivien; Sutanto, Anyeliria; Stevano, Reza; Djuanda, Gerald
Acta Neurologica Indonesia Vol. 1 No. 01 (2023): Acta Neurologica Indonesia
Publisher : Departemen Neurologi Fakultas Kedokteran Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69868/ani.v1i01.7

Abstract

Introduction: Cases of tuberculosis is still highly prevalent in the world, including Indonesia.Tuberculous meningoencephalitis (TBME) is the most severe form of tuberculosis. This study aims to establish the factors affecting prognosis in TBME. Objective: To Identify the clinical factors that affect the prognosis of tuberculous meningoencephalitis patients. Material and Methods: This is cross-sectional study evaluating factors (clinical features, imaging, and treatment) affecting prognosis in TBME patients who underwent treatment in Siloam Hospitals Lippo Village. Univariate analyses was done, followed by bivariate analyses with logistic regression to compare factors between good (Glasgow outcome scale [GOS] 4-5) and poor (GOS 1-3) prognosis. Results and Discussion: 64 patients were included. On univariate analysis, significant differences was found between Glasgow coma scale (GCS) scores (p=0.012), clinical features of meningeal irritation (p=0.004), findings of hydrocephalus (p=0.023) and vasculitis/infarction (p=0.020) on imaging, antibiotic use (p=0.013), and MRC grading (p=0.008). On logistic regression, 4 factors were found to be significant: headache (OR 5.398 95% CI 1.165-25.008, p=0.031), meningeal irritation (OR 0.146 95% CI 0.026-0.813, p=0.028), hydrocephalus (OR 0.167 95% CI 0.032-0.881, p=0.035), and antibiotic use (OR 0.155 95% CI 0.034-0.717, p=0.017). Conclusion: Clinical manifestations of meningeal irritation and altered consciousness, imaging findings of hydrocephalus and vasculitis/infarction, and antibiotic usage is associated with poor prognosis, while presence of headache is associated with a better prognosis.
Co-Authors Amiruddin Aliah, Amiruddin Budhianto Suhadi Cahyono Kaelan, Cahyono Cenweikiawan, Anderson Chandra, Anastasya Djuanda, Gerald Eka J. Wahjoepramono Evelyn Yunita Harsono, Ivan William Hartoyo, Vinson Ilhamjaya Patellongi Ivan William Harsono Jan S. Purba, Jan S. Japutri, Josephine Julius July Ketaren, Retno Jayantri M.T. Siahaan, Yusak Made Agus Mahendra Inggas, Made Agus Mahendra Nathania Victoria Stevina Pangestu, Aristo Pangestu, Aristo Rinaldi Situmeang, Rocksy Fransisca V. Solansa, Tracy Stevano, Reza Stevina, Nathania Victoria Sutanto, Anyeliria Syarifuddin Wahid Tiffani, Pamela Wahyoepramono, Julianta Widjaja, Devita Yong, Yee Wen