Three-year mortality in cryptococcal meningitis: Hyperglycemia predict unfavorable outcome

PLoS One. 2021 May 28;16(5):e0251749. doi: 10.1371/journal.pone.0251749. eCollection 2021.

Abstract

Existing evidence revealed grave prognosis for cryptococcal meningitis (CM), particularly its short-term mortality. However, its long-term survival and prognostic factors remained unknown. This study investigated 3-year mortality and analyzed its predictive factors in patients with CM. This retrospective cohort study with 83 cerebrospinal fluid culture-confirmed CM patients was conducted at China Medical University Hospital from 2003 to 2016. The 3-year mortality rate in patients with CM was 54% (45 deaths among 83 patients). Advanced age, human immunodeficiency virus (HIV) seronegative state, low Glasgow Coma Scale score on admission, decreased hemoglobin and hyperglycemia on diagnosis were associated with 3-year mortality. After multivariate adjustment in the Cox proportional hazard model, only severe hyperglycemia (serum glucose ≥200 mg/dL) on diagnosis could predict 3-year mortality.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Cryptococcus neoformans / immunology
  • Cryptococcus neoformans / isolation & purification
  • Female
  • Follow-Up Studies
  • Glasgow Coma Scale
  • HIV Seronegativity / immunology*
  • Humans
  • Hyperglycemia / diagnosis
  • Hyperglycemia / epidemiology*
  • Hyperglycemia / immunology
  • Hyperglycemia / microbiology
  • Male
  • Meningitis, Cryptococcal / complications
  • Meningitis, Cryptococcal / diagnosis
  • Meningitis, Cryptococcal / immunology
  • Meningitis, Cryptococcal / mortality*
  • Middle Aged
  • Prognosis
  • Retrospective Studies
  • Risk Assessment / methods
  • Risk Assessment / statistics & numerical data
  • Risk Factors

Grants and funding

This study was supported by grants from the Ministry of Science and Technology, Taiwan (Grant number: MOST 108-2314-B-039-038-MY3 and MOST 109-2321-B-468- 001) and from CMUH (DMR-109-130). This study was not sponsored by industry. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.