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KMID : 1001920140560010034
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Journal of Korean Neurosurgical Society
2014 Volume.56 No. 1 p.34 ~ p.41
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Risk Factors Associated with Poor Outcomes in Patients with Brain Abscesses
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Ko Seok-Jin
Park Kyung-Jae
Park Dong-Hyuk
Kang Shin-Hyuk
Park Jung-Yul
Chung Yong-Gu
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Abstract
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Objective: The purpose of this study was to describe the clinical characteristics, treatment outcomes, and prognostic factors in patients with brain abscesses treated in a single institute during a recent 10-year period.
Methods: Fifty-one patients with brain abscesses who underwent navigation-assisted abscess aspiration with antibiotic treatment were included in this study. Variable parameters were collected from the patients’ medical records and radiological data. A comparison was made between patients with favorable [Glasgow Outcome Scale (GOS) ≥4] and unfavorable (GOS <4) outcomes at discharge. Additionally, we investigated the factors influencing the duration of antibiotic administration.
Results: The study included 41 male and 10 female patients with a mean age of 53 years. At admission, 42 patients (82%) showed either clear or mildly disturbed consciousness (GCS ≥13) and 24 patients (47%) had predisposing factors. The offending microorganisms were identified in 25 patients (49%), and Streptococcus species were the most commonly isolated bacteria (27%). The mean duration of antibiotic administration was 42 days. At discharge, 41 patients had a favorable outcome and 10 had an unfavorable outcome including 8 deaths. The decreased level of consciousness (GCS <13) on admission was likely associated with an unfavorable outcome (p=0.052), and initial hyperglycemia (≥140 mg/dL) was an independent risk factor for prolonged antibiotic therapy (p=0.032).
Conclusion: We found that the level of consciousness at admission was associated with treatment outcomes in patients with brain abscesses. Furthermore, initial hyperglycemia was closely related to the long-term use of antibiotic agents.
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KEYWORD
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Brain abscess, Glasgow Coma Scale, Glasgow Outcome Scale, Hyperglycemia
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