Risk factors associated with death or neurological deterioration among patients with Gram-negative postneurosurgical...

Area of Science:

• Neuroscience
• Infectious Diseases
• Critical Care Medicine

Background:

• Gram-negative meningitis following neurosurgery presents significant challenges.
• Early identification of risk factors is essential for improving patient outcomes.

Purpose of the Study:

• To identify predictors of 30-day mortality or neurological deterioration in Gram-negative postneurosurgical meningitis.
• To develop and validate a predictive score for patient risk stratification.

Main Methods:

• Retrospective cohort study of 115 patients with Gram-negative postneurosurgical meningitis.
• Multivariate analysis to identify independent risk factors.
• Development and validation of a predictive score using patient data.

Main Results:

• Factors associated with adverse outcomes included delayed meningitis diagnosis, decreased consciousness, hyperglycemia (>180 mg/dL), elevated creatinine, and low cerebrospinal fluid glucose (<50 mg/dL).
• A predictive score effectively stratified patients into low, intermediate, and high-risk groups for unfavorable outcomes (9.1%, 42.1%, and 66.7% respectively).
• The predictive score demonstrated acceptable validation in an independent cohort of 36 patients.

Conclusions:

• Several clinical and biochemical parameters at diagnosis are significant predictors of poor outcomes in Gram-negative postneurosurgical meningitis.
• The developed predictive score offers a valuable tool for risk stratification and guiding clinical management in these high-risk patients.