title: Risk factors associated with death or neurological deterioration among patients with Gram-negative postneurosurgical meningitis.
abstract: In a retrospective cohort of 115 patients with Gram-negative postneurosurgical meningitis, factors associated with 30-day mortality or neurological deterioration on multivariate analysis included days from admission to meningitis (OR 1.05 per day, 95% CI 1.02-1.09), decreased level of consciousness (OR 2.69, 95% CI 0.99-7.31), blood glucose level >180 mg/dL (OR 3.70, 95% CI 1.27-10.77), higher creatinine level (OR 4.07 per 1 mg/dL, 95% CI 1.50-11.08), and cerebrospinal fluid glucose <50 mg/dL (OR 5.02, 95% CI 1.71-14.77) at diagnosis. A predictive score triaged patients into three groups with low (4/44, 9.1%), intermediate (16/38, 42.1%) and high (22/33, 66.7%) unfavourable outcome rates. Validation on a different group of 36 patients with Gram-negative postneurosurgical meningitis was acceptable.
authors.affiliation: Division of Infectious Diseases, Rambam Health Care Campus, Haifa, Israel; Internal Medicine B, Rambam Health Care Campus, Haifa, Israel; Rappaport Faculty of Medicine, Technion, Haifa, Israel. Electronic address: a_neuberger@rambam.health.gov.il.
authors.forename: A
authors.initials: A
authors.lastname: Neuberger
authors.affiliation: Department of Neurosurgery, Tel-Aviv Medical Centre, Tel-Aviv, Israel.
authors.forename: B
authors.initials: B
authors.lastname: Shofty
authors.affiliation: Internal Medicine B, Rambam Health Care Campus, Haifa, Israel.
authors.forename: B
authors.initials: B
authors.lastname: Bishop
authors.affiliation: Rappaport Faculty of Medicine, Technion, Haifa, Israel; Department of Rheumatology, Rambam Health Care Campus, Haifa, Israel.
authors.forename: M E
authors.initials: ME
authors.lastname: Naffaa
authors.affiliation: Rappaport Faculty of Medicine, Technion, Haifa, Israel.
authors.forename: T
authors.initials: T
authors.lastname: Binawi
authors.affiliation: Medicine E, Rabin Medical Centre, Beilinson Hospital, Petah-Tikva, Israel.
authors.forename: T
authors.initials: T
authors.lastname: Babich
authors.affiliation: Neurosurgery, Rabin Medical Centre, Beilinson Hospital, Petah-Tikva, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Israel.
authors.forename: Z H
authors.initials: ZH
authors.lastname: Rappaport
authors.affiliation: Rappaport Faculty of Medicine, Technion, Haifa, Israel; Department of Neurosurgery, Rambam Health Care Campus, Haifa, Israel.
authors.forename: M
authors.initials: M
authors.lastname: Zaaroor
authors.affiliation: Rappaport Faculty of Medicine, Technion, Haifa, Israel; Department of Neurosurgery, Rambam Health Care Campus, Haifa, Israel.
authors.forename: G
authors.initials: G
authors.lastname: Sviri
authors.affiliation: Medicine E, Rabin Medical Centre, Beilinson Hospital, Petah-Tikva, Israel.
authors.forename: D
authors.initials: D
authors.lastname: Yahav
authors.affiliation: Division of Infectious Diseases, Rambam Health Care Campus, Haifa, Israel; Rappaport Faculty of Medicine, Technion, Haifa, Israel.
authors.forename: M
authors.initials: M
authors.lastname: Paul
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000150:complications / Q000401:mortality*; D006801:Humans; D008297:Male; D016920:Meningitis, Bacterial / Q000150:complications / Q000401:mortality*; D008875:Middle Aged; D009422:Nervous System Diseases / Q000453:epidemiology*; D019635:Neurosurgical Procedures / Q000009:adverse effects*; D012189:Retrospective Studies; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000150:complications / Q000401:mortality*; D016019:Survival Analysis
keywords: Gram-negative; meningitis; neurosurgery; outcome; postneurosurgical; prognosis; prognostic factors; risk factors