High cerebrospinal fluid pressure measured at first lumbar puncture and mortality in acute infectious encephalitis
Abstract
OBJECTIVE
To identify the association between increased intracranial pressure and mortality in patients with acute encephalitis.
METHODS
We conducted a retrospective cohort study using the database from Khon Kaen Hospital, Thailand from January 2011 to May 2017 with preliminary diagnosis as acute infectious encephalitis undergoing lumbar puncture with measured open pressure. Mortality was our primary outcome.
RESULTS
From 291 patients with acute infectious encephalitis. From Cox regression model analysis, we found no significant association between high open pressure (more than or equal 27 cmH2O) and mortality (hazard ratio (HR), 1.34; 95% confidence interval (CI), 0.79 to 2.28). Also, by using Kaplan-Meier survival analysis, there was no significant association between high open pressure and mortality (P=0.263). However, the incidence density of mortality significantly increased 1.02 times in each year of patient age (HR, 1.02; 95% CI, 1.01 to 1.04), and a subgroup analysis of various cut-point showed incidence density of mortality significantly increased 2.18 times in patients with open pressure more than or equal to 20 cmH2O (HR, 2.18; 95% CI, 1.29 to 3.70).
CONCLUSION
High cerebrospinal fluid open pressure was not associated with mortality of patients with acute infectious encephalitis.
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