Drug-induced liver injury as a strong independent predictor of in-hospital mortality in tuberculous meningitis: potential age-related effect modification suggested in a large lifespan cohort - Summary - MDSpire
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Drug-induced liver injury as a strong independent predictor of in-hospital mortality in tuberculous meningitis: potential age-related effect modification suggested in a large lifespan cohort
To quantify the independent association of drug-induced liver injury (DILI) with in-hospital mortality in a large HIV-negative tuberculous meningitis (TBM) cohort and to evaluate specific age-related effect modifications.
Key Findings:
In-hospital mortality rate was 11.9% (187/1,574) and DILI occurred in 13.8% (217/1,574).
DILI was independently associated with in-hospital mortality (aOR 8.536; 95% CI 5.970–12.245; P < 0.001).
Adding DILI to predictive models improved the AUC from 0.661 to 0.805 (ΔAUC = 0.144).
Median time from treatment initiation to DILI onset was 23 days.
Age-DILI interaction showed a borderline trend (P = 0.069).
Interpretation:
DILI is a strong independent predictor of in-hospital mortality in TBM patients, with implications for monitoring and management.
Limitations:
Single-center study may limit generalizability and introduce bias due to retrospective design.
Potential confounding factors not fully accounted for.
Conclusion:
DILI significantly predicts in-hospital mortality in TBM, suggesting the need for intensive monitoring and early intervention to improve patient outcomes.
