Prognostic indicators of the outcome of meningococcal disease: a study of 562 patients

• Published in: Journal of medical microbiology Vol. 45; no. 1; pp. 16 - 20
• Main Authors: LODDER, MARIETTE C, SCHILDKAMP, REGINA L, BIJLMER, H. A, DANKERT, J, KUIK, D. J, SCHOLTEN, R. J. P. M
• Format: Journal Article
• Language: English
• Published: Reading Soc General Microbiol 01.07.1996; Society for General Microbiology
• Subjects: Adolescent; Adult; Bacterial diseases; Bacterial diseases of the nervous system. Bacterial myositis; Biological and medical sciences; Blood Pressure; Body Temperature; Causality; Child; Child, Preschool; Female; Follow-Up Studies; Human bacterial diseases; Humans; Infant; Infant, Newborn; Infectious diseases; Leukocyte Count; Logistic Models; Male; Medical sciences; Meningococcal Infections - mortality; Middle Aged; Multivariate Analysis; Netherlands - epidemiology; Odds Ratio; Platelet Count; Prognosis; Prospective Studies; Surveys and Questionnaires; Netherlands; Human; Nervous system diseases; Prognosis; Neisseriaceae; Neisseria meningitidis; Bacteremia; Indicator; Infection; Central nervous system disease; Risk factor; Predisposition; Bacteriosis; Bacteria; Micrococcales; Meningitis; Age; Meningococcal disease
• ISSN: 0022-2615; 1473-5644
• DOI: 10.1099/00222615-45-1-16

Institute for Research in Extramural Medicine, Vrije Universiteit, Amsterdam * Hospital "Bronovo", The Hague Netherlands Reference Laboratory for Bacterial Meningitis, WHO Collaborating Centre, University of Amsterdam/National Institute for Public Health and Protection, Amsterdam Department of Epidemiology and Biostatistics, Vrije Universiteit, Amsterdam, The Netherlands Corresponding author: Dr. R. J. P. M. Scholten. Received April 13, 1995 Accepted November 29, 1995 To assess prognostic indicators of a fatal outcome in patients with meningococcal disease, data from 562 patients with culture-proven meningococcal disease, reported in the Netherlands between 1 April 1989 and 30 April 1990, were collected prospectively by means of a questionnaire completed by the specialist in attendance. Analysis was done by the X 2 test and multiple logistic regression. During the study period 43 patients (7.7%) died. The risk of a fatal outcome was increased in patients aged 0-5 months, 10-19 years, and > 50 years, in female patients and in patients presenting with coma, temperature > 38.0°, mean arterial pressure > 70 mmHg, white blood cell count > 10 x 10 9 /L and platelet count > 100 x 10 9 /L. Predisposing factors and duration of disease before admission were significantly associated with outcome, but these associations disappeared in the multivariate analysis. Race, the administration of antibiotics prior to admission, seizures and haemorrhagic skin lesions were not associated with outcome. In conclusion age, gender, coma, temperature, mean arterial pressure, white blood cell count and platelet count were independent prognostic indicators of the outcome of meningococcal disease. The assessment of these characteristics may be helpful for the identification of high risk patients, whose prognosis might be improved by prompt transfer to an intensive care unit.