Journal of Korean Neurosurgical Society

  • 제56권1호
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  • Pages.34-41
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  • 2014
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  • 2005-3711(pISSN)
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  • 1598-7876(eISSN)
대한신경외과학회 (The Korean Neurosurgical Society)
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Risk Factors Associated with Poor Outcomes in Patients with Brain Abscesses

  • Ko, Seok-Jin (Department of Neurosurgery, Korea University Medical Center, College of Medicine, Korea University) ;
  • Park, Kyung-Jae (Department of Neurosurgery, Korea University Medical Center, College of Medicine, Korea University) ;
  • Park, Dong-Hyuk (Department of Neurosurgery, Korea University Medical Center, College of Medicine, Korea University) ;
  • Kang, Shin-Hyuk (Department of Neurosurgery, Korea University Medical Center, College of Medicine, Korea University) ;
  • Park, Jung-Yul (Department of Neurosurgery, Korea University Medical Center, College of Medicine, Korea University) ;
  • Chung, Yong-Gu (Department of Neurosurgery, Korea University Medical Center, College of Medicine, Korea University)
  • 투고 : 2014.04.09
  • 심사 : 2014.07.15
  • 발행 : 2014.07.28
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초록

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) ${\geq}4$] 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 ${\geq}13$) 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 (${\geq}140mg/dL$) 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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참고문헌

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