Risk factors for adverse outcomes of bacterial meningitis.
OBJECTIVE
To identify risk factors for adverse outcomes from bacterial meningitis.


METHODS
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 B/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 < or = 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 < or = 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.
Grimwood
K
K
Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia.
Nolan
T M
TM
Bond
L
L
Anderson
V A
VA
Catroppa
C
C
Keir
E H
EH
D000293:Adolescent; D000367:Age Factors; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D003072:Cognition Disorders / Q000209:etiology; D016001:Confidence Intervals; D002658:Developmental Disabilities / Q000453:epidemiology / Q000209:etiology*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006311:Hearing Disorders / Q000209:etiology; D006801:Humans; D007223:Infant; D008607:Intellectual Disability / Q000209:etiology; D016015:Logistic Models; D008297:Male; D016920:Meningitis, Bacterial / Q000150:complications* / Q000453:epidemiology; D008586:Meningitis, Pneumococcal / Q000150:complications; D016017:Odds Ratio; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D012640:Seizures / Q000150:complications; D017741:Survivors; D014739:Victoria / Q000453:epidemiology