Predictive Factors of the Outcome and Intraventricular Rupture of Brain Abscess
Thara Tunthanathip MD*, Kanet Kanjanapradit MD**, Sakchai Sae-Heng MD*, Thakul Oearsakul MD*, Ittichai Sakarunchai MD*
Affiliation : * Division of Neurological Surgery, Department of Surgery, Faculty of Medicine, Songklanagarind Hospital, Prince of Songkla University, Songkhla, Thailand ** Department of Pathology, Faculty of Medicine, Songklanagarind Hospital, Prince of Songkla University, Songkhla, Thailand
Objective : To identify the significant factors predicting a favorable outcome and to study clinical characteristics and identify
the factors predicted by intraventricular rupture of brain abscess (IVROBA).
Material and Method: In the retrospective study, the computer-based medical records of patients of a tertiary care hospital
between 1999 and 2013 were reviewed. Univariate and multivariate analyses were used to determine the significant factors
predicting the outcomes and IVROBA.
Results : One hundred fourteen patients with brain abscesses were enrolled. The predictive factor of a favorable outcome
was Glasgow Coma Scale (GCS) score 13 to 15 (OR 14.64; 95% CI 2.70-79.34; p = 0.02). Conversely, the factors associated
with an unfavorable outcome were fungal brain abscess (OR 40.81; 95% CI 3.57-466.49; p = 0.003) and IVROBA
(OR 5.50; 95% CI 1.34-22.49; p = 0.017). Moreover, greater distance of the brain abscess from the ventricle decreased the
IVROBA (OR 0.62; 95% CI 0.45-0.87; p = 0.005). Abscesses with intraventricular rupture that were at less than 7 mm of
a ventricle (p<0.000) were likely to IVROBA.
Conclusion : The outcome of a brain abscess depends on good clinical status, pathogens, and fatal complication of IVROBA.
If poor prognostic factors exist, then better surgical option can be selected.
Keywords : Brain abscess, Intraventricular rupture, Ventriculitis, Fungal brain abscess, Predictive factor
