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Risk factors for adverse outcomes of bacterial meningitis |
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| Authors: | K GRIMWOOD TM NOLAN L BOND VA ANDERSON C CATROPPA EH KEIR |
| Affiliation: | Department of Paediatrics, Epidemiology and Biostatistics Unit, University of Melbourne, Parkville, Victoria, Australia;Department of Psychology, Epidemiology and Biostatistics Unit, University of Melbourne, Parkville, Victoria, Australia;Department of Clinical, Epidemiology and Biostatistics Unit, University of Melbourne, Parkville, Victoria, Australia;Department of General Paediatrics, Royal Children's Hospital, Parkville, Victoria, Australia;Department of Psychology, Royal Children's Hospital, Parkville, Victoria, Australia;Department of Audiology, Royal Children's Hospital, Parkville, Victoria, Australia |
| Abstract: | Objective : To identify risk factors for adverse outcomes from bacterial meningitis. Methodology : From a cohort of 166 children with bacterial meningitis who were studied prospectively, 130/158 (82%) survivors underwent neurological, neuropsychological, audiological and behaviour assessments 5–9 years following their illness. Results : Major adverse outcomes included 8/166 (4.8%) deaths and severe neurological, intellectual or audiological sequelae in 11/130 (8.5%) children followed. Another 24 (18.5%) had cognitive, auditory or behaviour disorders. Bivariate analysis found age ≤12 months, tertiary referral, symptoms >24 h before diagnosis, seizures, focal neurological signs, deteriorating conscious state in hospital, Streptococcus pneumoniae infection and serum sodium concentration < 130 mmol/L were associated with adverse outcomes. Multivariate analysis showed age ≤12 months, symptoms >24 h, seizures after 72 h in hospital and focal neurological signs as independent risk factors. These were present in 18/19 (95%) children with major sequelae, but absent in 9/24 (37.5%) children with minor disabilities. Conclusions : As minor disabilities following meningitis cannot be predicted, all survivors require assessment during their early school years. |
| Keywords: | disability meningitis seizures |