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Coagulation, coma, and outcome in bacterial meningitis--an observational study of 38 adult cases

Maciej Michał Kowalik1, Tomasz Smiatacz, Maria Hlebowicz

  • 1Department of Anaesthesiology and Intensive Therapy, Medical University of Gdańsk, ul. Debinki 7, 80-211 Gdańsk, Poland. mkowalik@amg.gda.pl

The Journal of Infection
|April 3, 2007
PubMed
Abstract

Insights

Intravascular coagulation is common in bacterial meningitis, affecting most patients. Activated coagulation correlates with severe disease, coma, and poor outcomes, highlighting its clinical significance.

Area of Science:

  • Medical Microbiology
  • Hematology
  • Critical Care Medicine

Background:

  • Bacterial meningitis is a severe infection with significant morbidity and mortality.
  • Intravascular coagulation, a complex process involving blood clotting, can complicate severe infections.

Purpose of the Study:

  • To investigate the occurrence of intravascular coagulation in bacterial meningitis.
  • To determine the relationship between coagulation abnormalities, disease severity, and patient outcomes.

Main Methods:

  • Prospective observational study of 38 adult patients with confirmed bacterial meningitis.
  • Monitoring of coagulation parameters including platelet count (PLT), platelet decline (dPLT), prothrombin ratio (PTr), INR, and D-dimer levels.
  • Correlation of coagulation markers with disease severity (Glasgow Coma Scale, APACHE-III) and outcome (Glasgow Outcome Scale).

Main Results:

  • High prevalence of coagulation activation: D-dimer (88%), dPLT (50%), PLT (38%), INR (36%), PTr (30%).
  • Patients with severe neurological impairment (GCS <9) showed significantly higher rates of coagulation activation.
  • Unfavorable outcomes (GOS 1-4) were strongly associated with abnormal PLT, PTr, INR, and elevated D-dimer levels.

Conclusions:

  • Coagulation activation is a frequent complication in bacterial meningitis.
  • The degree of coagulation activation is linked to disease severity and predicts unfavorable patient outcomes.

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