Clinical characteristics of tuberculous meningitis children with malnutrition and their relationships with short-term outcomes
Objective To investigate the clinical characteristics of malnutrition in children with tuberculous meningitis(TBM)and their relationships with short-term TBM outcomes.Methods A total of 80 TBM children admitted to the Department of Pediatrics,Guangzhou Chest Hospital from February 2016 to April 2022 were retrospectively selected as the study objects.According to the diagnostic criteria for malnutrition,the children were divided into a malnutrition group(66 cases)and a non-malnutrition group(14 cases).There were 35 boys and 31 girls in the malnutrition group;6 cases aged 1 month-＜1 year,19 cases aged 1-＜3 years,11 cases aged 3-＜6 years,and 30 cases aged 6-＜18 years;64 cases lived in villages and towns,and 2 cases in cities.There were 9 boys and 5 girls in the non-malnutrition group;1 case aged 1 month-＜1 year,3 cases aged 1-＜3 years,2 cases aged 3-＜6 years,and 8 cases aged 6-＜18 years;7 cases lived in villages and towns,and 7 cases in cities.The clinical characteristics of the two groups and their relationships with short-term outcomes were compared.x2 test and Fisher exact probability method were used.Results Among the 80 children with TBM,82.5％(66/80)were complicated with malnutrition,71.2％(57/80)with anemia,and 51.2％(41/80)with hypoalbuminemia.The proportions of the malnutrition group living in villages and towns[97.0％(64/66)]and with disease course＞14 days[81.2％(52/66)]were higher than those of the non-malnutrition group[50.0％(7/14)and 35.7％(5/14)](both P＜0.05).The incidences of anemia[77.2％(51/66)],hypoalbuminemia[57.6％(38/66)],drug-induced liver injury[51.5％(34/66)],sequelae[48.5％(32/66)],and abnormal cerebrospinal fluid findings at discharge[60.6％(40/66)]in the malnutrition group were all higher than those in the non-malnutrition group[42.8％(6/14),21.4％(3/14),21.4％(3/14),14.3％(2/14),and 35.7％(5/14)](all P＜0.05).There was no statistically significant difference in the clinical stage,hydrocephalus,spinal cord lesions,or mortality between the two groups(all P＞0.05).Conclusions Malnutrition is prevalent among children with TBM,and is associated with worse short-term outcomes.Early identification of nutritional risks and prompt nutritional support are essential in managing TBM in children.
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