title: [Occurrence of disseminated intravascular coagulation in purulent meningitis and influence on mortality in 118 patients].
abstract: Disseminated intravascular coagulation (DIC) is an important, but not satisfactory explained risk factor of death in purulent meningitis (PM).
  
  
  OBJECTIVE
  Evaluation of: 1) acute thrombocytopenia (ATP) in patients with PM, 2) dynamics in changes of peripheral blood platelet (PLT) count and serum coagulation factors, 3) correlation between acute DIC and mortality in PM.
  
  
  METHODS
  Analysis ofATP (platelets < or = 150 K/microL and/or decrease in PLT > or = 100 K/microL/24 hours) and prothrombin ratio, fibrinogen, d-dimmer and antithrombin III in survivors and nonsurvivors in 118 adult patients with PM. 37 further patients have been disclosed because of non-bacterial PM or chronic conditions predisposing to ATP or DIC.
  
  
  METHODS
  DIC defined as ATP occurred in 56 %, defined as elevated d-dimmer level in 72%. 16 (14%) patients died.
  
  
  RESULTS
  Mortality correlated significantly with the lowest PLT count on first 3. days (p=0,049) and with PLT decline (p=0,015). Differences in survivors/nonsurvivors were observed in: ATP on 1. day 48% vs. 75% (p<0,05), daily PLT decline 9%/day vs. 32%/day (p<0,05), prothrombin ratio 89% vs. 74% (p<0,05) and INR 1,2 vs. 1,7 (p<0,005).
  
  
  CONCLUSIONS
  DIC is an important risk factor in PM. Aggravated DIC do correlate significantly with higher risk of death.
authors.affiliation: Klinika Chorób Zakaźnych, Instytut Chorób Wewnetrznych Akademia Medyczna w Gdańsku. mkowalik@amg.gda.pl
authors.forename: Maciej Michał
authors.initials: MM
authors.lastname: Kowalik
authors.forename: Tomasz
authors.initials: T
authors.lastname: Smiatacz
authors.forename: Maria
authors.initials: M
authors.lastname: Hlebowicz
authors.forename: Robert
authors.initials: R
authors.lastname: Pajuro
authors.forename: Nina
authors.initials: N
authors.lastname: Dziarmaga-Piasecka
authors.forename: Marta
authors.initials: M
authors.lastname: Gesing
authors.forename: Barbara
authors.initials: B
authors.lastname: Richter-Kowalik
authors.forename: Barbara
authors.initials: B
authors.lastname: Zaborska
authors.forename: Hanna
authors.initials: H
authors.lastname: Trocha
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001922:Brain Abscess / Q000097:blood / Q000453:epidemiology; D002423:Cause of Death; D015897:Comorbidity; D004211:Disseminated Intravascular Coagulation / Q000097:blood* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D016920:Meningitis, Bacterial / Q000097:blood* / Q000453:epidemiology*; D008875:Middle Aged; D010976:Platelet Count; D012189:Retrospective Studies; D015996:Survival Rate; D013921:Thrombocytopenia / Q000097:blood