Neurological sequelae and fatality as prognostic measures in 875 cases of bacterial meningitis

Based on a review of medical records, we have analysed the outcome after bacterial meningitis among 875 patients admitted during the period 1966-1976. The outcome was evaluated not only by fatality during admission or within 4 weeks after discharge, but also by neurological sequelae at the time of discharge. These two types of outcome were determined and compared in subgroups of patients categorised according to a number of features of prognostic significance. This has allowed us to quantify the clinical conditions and features with regard to the severity of the prognosis. In most subgroups of patients, the frequencies of fatality and sequelae followed the same patterns: High frequencies were associated with pneumococcal meningitis, rare bacterial aetiologies, increasing age, affected consciousness on admission, pneumonia on admission, convulsions during admission, and respiratory problems during admission. For some prognostic features, a correlation could be established with high sequelae rates, but not with high fatality rates. This was the case with increased duration of disease symptoms before admission, with alcoholism and with previous head trauma. Thus, this correlation revealed the importance of early hospitalisation. We find that the analysis of sequelae not only supports, but also adds important prognostic information to the results obtained by an analysis of fatality itself in this large retrospective clinical study.