Prognostic indicators in bacterial meningitis: a case–control study

Abstract

This was a case–control study to identify prognostic indicators of bacterial meningitis in a reference hospital in Pernambuco/Brazil. The data were collected from charts of 294 patients with bacterial meningitis between January 2000 and December 2004. Variables were grouped in biological, clinical, laboratory and etiologic agent/treatment. Variables selected in each step were grouped and adjusted for age. Two models were created: one containing clinical variables (clinical model) and other containing laboratory variables (laboratory model). In the clinical model the variables associated with death due to bacterial meningitis were dyspnea ( p = 0.006), evidence of shock ( p = 0.051), evidence of altered mental state ( p = 0.000), absence of headache ( p = 0.008), absence of vomiting ( p = 0.052), and age ≥40 years old ( p = 0.013). In the laboratory model, the variables associated with death due to bacterial meningitis were positive blood cultures ( p = 0.073) and thrombocytopenia ( p = 0.019). Identification of prognostic indicators soon after admission may allow early specific measures, like admission of patients with higher risk of death to Intensive Care Units.