Risk factors of lethality for acute bacterial meningitis

Abstract

Introduction: Despite progress in intensive medicine and the wide range of available antibiotics, acute bacterial meningitis (ABM) continues to be a neurological emergency associated with high lethality and morbidity, requiring immediate evaluation and management. Objective: Determine the risk factors for lethality by ABM. Methods: An analytical retrospective cross-sectional study was conducted in the Hospital Universitario de Pediatría "Dr. Agustín Zubillaga" (Barquisimeto, Lara Estate, Venezuela), between January - 2017 and December - 2020. Cox regression. Results: A total of 69 children with ABM were included in the analysis. The case-fatality rate was 15,9%. The factors associated with lethality were: children younger than 1 year, sepsis, syndrome of inappropriate secretion of antidiuretic hormone (SIADH), and Neisseria meningitidis infection. Through Cox regression model was identified as predictors for lethality in children with ABM: Sepsis (HR=8,457; CI95%: 1,495 – 47,841; p = 0,016), SIADH (HR=10,093; CI95%: 1,721 – 59,206; p = 0,010) and Neisseria meningitidis infection (HR=8,758; CI95%: 1,982 – 38,697; p = 0,004). Conclusions: Sepsis, SIADH and Neisseria meningitidis infection were identified as independent variables related to lethality in children with ABM.