| Sumario: | Purpose: To evaluate the relationship between intracranial hyperpressure (HICP) and mortality in patients with cryptococcal meningitis related to AIDS (CMRA). Methods: This was an observational retrospective study. Patients were treated according to the Infectious Diseases Society of America recommendations during the evaluation period (days 0, 3, 5 and after hospitalization). High intracranial pressure (HICP) was defined as ICP values of ≥250 mm H 20. The correlation between HICP and mortality at each of the three time points considered was investigated. Statistical analysis on the descriptive parameters and on the probability of a “death” event (odds ratio, OR) at each of those three time points was performed using the statistical software program Epidata. Results: Eighty patients were included in this study, of whom 53 (66.25 %) were male. The average age of the patients was 37.5 ± 8.1 (range 22–55) years. The median CD4+ lymphocyte cell count was 35 (range 0–367) cells/ml. Among the entire patient cohort, 53 patients had a favorable outcome, and the mortality rate was 33.75 %. At baseline (day 0), 57 subjects (71.5 %) presented HICP, and these patients had a higher mortality rate than those with a normal ICP, but the difference did not reach statistical significance [OR 1.65, 95 % confidence interval (CI) 0.56–4.84]. On day 3, 41 of the patients presented HICP, and HICP at this time point was significantly associated with an increased risk of mortality (OR 4.35, 95 % CI 1.56–12.09). On day 5, 35 (43.5 %) patients presented HICP, and HCIP at this time point was also significantly associated with higher mortality (OR 7.23, 95 % CI 2.53–20.14). Conclusion: The results of this study confirm an association between HICP and mortality in patients with CMRA and indicate that the control of ICP during the first 5 days of hospitalization is more important than managing HICP only at baseline.
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