Background
Methods
Participants
Data collection
Statistical analysis and biomarker selection
Biomarker validation
Results
Baseline characteristics
Variable | n (%) or median (range) |
---|---|
Age (years) | 41 (10-87) |
Sex
| |
Male | 31 (60%) |
Ethnic Origin
| |
Asian | 32 (62%) |
Black-African | 11 (21%) |
White | 5 (10%) |
Other | 4 (8%) |
Previous diagnosis of TB
| 2 (4%) |
Co-morbidities
| |
None | 33 (63%) |
Diabetes | 6 (12%) |
CKD | 4 (8%) |
Anti-TNF therapy | 3 (6%) |
Alcoholism | 3 (6%) |
Heart failure | 2 (4%) |
HIV positive | 3/49 (6%) |
Hepatitis B sAg positive | 3/49 (6%) |
Hepatitis C positive | 1/47 (2%) |
Vitamin D deficient | 44/57 (94%) |
Admission blood tests
| |
Sodium (mmol/L) | 132 (106-141) |
Creatinine (mmol/L) | 68 (44-559) |
Alanine aminotransferase (IU/L) | 46 (5-453) |
Alkaline phosphatase (iU/L) | 121 (39-866) |
Bilirubin (μmol/L) | 12 (4-39) |
Erythrocyte sedimentation rate (mm/h) | 33 (1-127) |
C-reactive protein (mg/L) | 56 (3-433) |
White cell count (×109/L) | 7.1 (1.1-17.0) |
Neutrophil count (×109/L) | 5.3 (0.9-15.7) |
Platelet count (×109/L) | 238 (53-574) |
Ferritin (μg/L) | 522 (10-19,070) |
Vitamin D (nmol/L) | 16 (2-117) |
Assessment for CNS involvement
| |
Number of patients assessed for CNS infection | 29 (56%) |
- CT head consistent with CNS infection | 6/19 (32%) |
- MRI brain consistent with CNS infection | 10/11 (91%) |
- Lumbar puncture consistent with CNS infection | 4/17 (24%) |
Total number with confirmed CNS infection | 15 (29%) |
Outcomes and adverse events
| |
Death (by one-year) | 1 (2%) |
Mechanical ventilation | 8 (15%) |
Drug-induced hepatitis | 7 (13%) |
Seizure | 4 (8%) |
Pneumothorax | 3 (6%) |
Haemophagocytic lymphohistiocytosis | 2 (4%) |
Pericardial effusion | 2 (4%) |
Neuroimaging
Microbiology
Treatment
Complications
Parameter | Univariable | Multivariable | ||
---|---|---|---|---|
Odds ratio (95% CI) |
p-value | Odds ratio (95% CI) |
p-value | |
ALT (per 10 IU/L) | 1.29 (1.13-1.56) | <0.001 | 1.33 (1.11-1.78) | <0.001 |
Bilirubin (per 10 μmol/L) | 2.99 (1.29-7.84) | 0.01 | 0.69 (0.07-3.86) | 0.68 |
CRP (per 10 mg/L) | 1.14 (1.02-1.35) | 0.02 | 1.13 (0.93-1.61) | 0.27 |
Platelet count (per 100 cells/mm3) | 0.39 (0.14-0.87) | 0.02 | 0.75 (0.13-3.60) | 0.71 |
Sodium (per 10 mmol/L) | 0.40 (0.14-1.03) | 0.06 | 0.19 (0.02-0.93) | 0.04 |
Predictor | Outcome | Sensitivity (%) | Specificity (%) | PPV (%) | NPV (%) | AUC |
---|---|---|---|---|---|---|
ALT ≥180 IU/L | Unfavourable | 75.0 (41.7-100) | 97.3 (92.5-100) | 85.7 (50.0-100) | 95.6 (88.6-100) | 0.864 (0.692-1.00) |
Sodium <132 mmol/L | Unfavourable | 87.5 (57.1-100) | 61.4 (46.5-76.1) | 29.2 (11.1-48.3) | 96.4 (88.9-100) | 0.744 (0.583-0.869) |
ALT <180 IU/L & sodium ≥125 mmol/L | Favourable | 81.8 (69.8-92.5) | 100 (100-100) | 100 (100-100) | 50.0 (25.0-76.9) | 0.909 (0.849-0.963) |