The effect of therapeutic lumbar punctures on acute mortality from cryptococcal meningitis.
Bottom Line: The adjusted relative risk of mortality was 0.31 (95% confidence interval: .12-.82).The association was observed regardless of opening pressure at baseline.Therapeutic LPs were associated with a 69% relative improvement in survival, regardless of initial intracranial pressure.
Affiliation: Department of Medicine, Medical School.Show MeSH
Related in: MedlinePlus
Mentions: Four hundred seventy-four individuals were screened, and 257 were found to have cryptococcal meningitis and were considered for inclusion in this analysis. Nine individuals died or had a therapeutic LP on the same day as diagnosis and were excluded from further analysis, leaving 248 individuals for analysis (Figure 1). Included individuals were all HIV-infected and observed for a total of 1698 person-days (median follow-up 7 days [interquartile range [IQR]: 6–8 days]). The median age of the cohort was 36 years, median duration of headache was 2 weeks before diagnosis, 55% were male, and 29% had altered mental status (GCS <15).Figure 1.