Clinical features and outcome of brain abscess after introduction of CT and MRI: A meta-analysis
Abstract
OBJECTIVE
To describe the clinical features and outcome of brain abscess since introduction of computerized tomography and magnetic resonance imaging.
METHODS
MEDLINE and Embase were searched using "brain abscess" or "cerebral abscess" from 1970 through 2023 and analyses restricted to study populations hospitalized after 1980. Single-variable meta-analyses were done using a random-effects model.
RESULTS
A total of 21,840 patients from 209 studies were included. The mean age was 34 years (95% confidence interval [CI] 30-38) and 11,817/17,406 (66%, 95% CI 64-67) were male. The aetiologies were consistent across time and continents with Streptococcus spp. 2,064/6,393 (32%, 95% CI 28-36), Staphylococcus spp. 1,061/6,393 (14%, 95% CI 12-16), and Gram-negative enteric bacteria 696/6,393 (9%, 95% CI 7-11) as the most common. Predisposing conditions included otitis media/mastoiditis 1,909/6,433 (27%, 95% CI 22-33), immunocompromise 1,022/4,652 (19%, 95% CI 14-24), sinusitis 565/3,725 (16%, 95% CI 12-20), and neurosurgery 745/4,927 (16%, 95% CI 12-20). The case-fatality was 2,444/18,991 (12%, 95% CI 11-14) and good recovery was found in 3,419/5,409 (63%, 95% CI 58-68).
CONCLUSIONS AND RELEVANCE
Brain abscess remains a disease predominantly occurring in men and was caused by contiguous or distant infections. Case fatality and outcome have not improved during recent decades.
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 21,840 participants or records.
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