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Clinical features, laboratory data, management and the risk factors that affect the mortality in patients with
Ilknur Erdem1, Tayfun Hakan, Nurgul Ceran
1Department of Infectious Disease and Clinical Microbiology, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey. erdem_ilknur@yahoo.com
Background:
Nosocomial meningitis is a rare complication following neurosurgical procedures and is associated with high morbidity and mortality.
Aim:
The aim of this study was to describe the clinical characteristics and the risk factors associated with mortality in patients who developed nosocomial meningitis following neurosurgical operations.
Setting And Design:
Tertiary care hospital and an observational study.
Materials And Methods:
The study subjects included 2265 patients who underwent various neurosurgical operations during 2003-05. The diagnosis of nosocomial meningitis was based on the Center for Disease Control criteria.
Statistical Analysis:
It was performed by using Statistical Package for Social Sciences for Windows 10.0 program.
Results:
The incidence of postoperative nosocomial meningitis was 2.7% (62 episodes in 49 patients among 2265 patients operated). Staphylococcus aureus and Acinetobacter spp. were the most frequently isolated pathogens. Of the 49 with meningitis 20 (40.8%) patients died. In the logistic regression analysis model, Glascow coma scale score less than 10 (Odds Ratio (OR): 19.419, 95% Confidence Interval (CI); 1.637-230.41, P = 0.001), and low cerebrospinal fluid glucose level (< or = 30 mg/ dL) (OR: 10.272, 95% CI; 1.273-82.854, P = 0.002), and presence of concurrent nosocomial infection (OR: 28.744, 95% CI;1.647-501.73, P =0.001) were the independent risk factors associated with mortality.
Conclusion:
The mortality in patients who developed meningitis was high. The high percentage of concurrent nosocomial infections was associated with a high mortality rate which was a serious problem.
Insights
Nosocomial meningitis after neurosurgery is rare but deadly. Low Glasgow Coma Scale scores, low cerebrospinal fluid glucose, and concurrent infections significantly increase mortality risk in these patients.
Area of Science:
- Neurosurgery
- Infectious Diseases
- Critical Care Medicine
Background:
- Nosocomial meningitis is a rare but severe complication following neurosurgical procedures.
- It is associated with significant patient morbidity and mortality.
- Understanding risk factors is crucial for improving outcomes.
Purpose of the Study:
- To characterize clinical features of nosocomial meningitis post-neurosurgery.
- To identify independent risk factors for mortality in affected patients.
Main Methods:
- Observational study conducted at a tertiary care hospital.
- Included 2265 patients undergoing neurosurgical operations from 2003-2005.
- Diagnosis based on Center for Disease Control criteria; data analyzed using SPSS.
Main Results:
- Incidence of postoperative nosocomial meningitis was 2.7% (49 patients).
- Staphylococcus aureus and Acinetobacter spp. were common pathogens.
- Mortality rate was 40.8% (20 deaths).
- Independent risk factors for mortality included Glasgow Coma Scale < 10, low CSF glucose (< or = 30 mg/dL), and concurrent nosocomial infection.
Conclusions:
- Mortality associated with nosocomial meningitis post-neurosurgery is high.
- Concurrent nosocomial infections are a significant factor contributing to this high mortality rate.
- Early identification and management of risk factors are essential.
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