Demographic profiles and risk factors for mortality in acute meningitis: A nationwide population-based observational...

Area of Science:

• Neurology
• Infectious Diseases
• Public Health

Background:

• Acute meningitis is a serious inflammation of the membranes surrounding the brain and spinal cord.
• The specific mortality rates and risk factors for different types of acute meningitis (bacterial, viral, fungal, tuberculous, carcinomatous) are not well-established.
• Understanding these variations is critical for effective clinical management and public health strategies.

Purpose of the Study:

• To determine the incidence and mortality rates associated with various types of acute meningitis.
• To identify demographic characteristics and risk factors influencing mortality across different meningitis subtypes.
• To compare the epidemiological features and outcomes of bacterial, viral, fungal, tuberculous, and carcinomatous meningitis.

Main Methods:

• Utilized Japan's nationwide Diagnosis Procedure Combination (DPC) database, covering 1132 hospitals from 2016 to 2022.
• Analyzed data from 48,758 patients hospitalized with acute meningitis.
• Categorized meningitis types and analyzed demographic data, mortality rates, and specific pathogen-associated risks.

Main Results:

• Acute meningitis affected 0.10% of hospitalized patients, with viral meningitis being most common (29,486 cases), followed by bacterial (10,338 cases).
• Mortality rates varied significantly: carcinomatous (39%), fungal (21%), bacterial (estimated), and viral (0.61%).
• Mortality increased with age, and specific pathogens like *Staphylococcus aureus* and herpes simplex virus were linked to higher mortality.

Conclusions:

• Significant differences in demographics and mortality exist among acute meningitis types.
• Less common meningitis types, such as carcinomatous and fungal, present high mortality risks.
• There is a need to refine diagnostic and treatment strategies for all forms of acute meningitis, especially rarer types.