Factors Associated with In-Hospital Mortality in Adult Patients with Bacterial Meningitis

Area of Science:

• Infectious Diseases
• Critical Care Medicine
• Neurology

Background:

• Community-acquired bacterial meningitis (BM) is a serious infection with significant mortality.
• Identifying predictors of in-hospital mortality is crucial for timely intervention and improved patient outcomes.

Purpose of the Study:

• To evaluate the association between various clinical and laboratory findings and in-hospital mortality in adult patients with community-acquired bacterial meningitis (BM).

Main Methods:

• Retrospective analysis of 339 adult patients with BM admitted between January 2010 and December 2017.
• Data collected included clinical presentation, laboratory results (blood and cerebrospinal fluid), and scoring systems like Glasgow Coma Scale (GCS) and Sequential Organ Failure Assessment (SOFA).
• Multiple logistic regression analysis was used to identify independent predictors of in-hospital mortality.

Main Results:

• In-hospital mortality was observed in 16.5% of patients (56 out of 339).
• Non-survivors exhibited lower GCS scores, higher SOFA scores, were more likely to be immunocompromised, and had a higher prevalence of Streptococcus pneumoniae etiology.
• Key predictors of death included lower GCS, higher SOFA, age over 70 years, and S. pneumoniae infection.

Conclusions:

• Significant differences exist between survivors and non-survivors of BM concerning clinical signs, etiology, laboratory findings, immune status, and severity scores.
• GCS, SOFA scores, advanced age, and S. pneumoniae etiology are strongly associated with in-hospital mortality in BM patients.