Borg Jennie, Christie Deborah, Coen Pietro G, Booy Robert, Viner Russell M
MBBS, University College Hospital, Department of Paediatrics, 250 Euston Rd, London NW1 2PG, United Kingdom.
Pediatrics. 2009 Mar;123(3):e502-9. doi: 10.1542/peds.2008-0581.
We examined the physical, cognitive, educational, social, and psychological outcomes of invasive meningococcal disease in adolescence, as well as demographic and disease factors associated with outcomes.
A population-based, matched-cohort study was performed. A total of 101 gender- and age-matched case-control pairs (15-19 years of age at the time of disease; 46% male) from 6 regions of England underwent follow-up evaluations 18 to 36 months after invasive meningococcal disease. Educational, social, and vocational function, mental health, social support, self-efficacy, and quality-of-life data were collected by using standardized questionnaires and neuropsychological tests.
Fifty-seven percent of case subjects (n = 58) had major physical sequelae. Survivors had greater depressive symptoms, greater fatigue, less social support, greater reduction in quality of life, and lower educational attainment compared with control subjects. Survivors with serogroup C disease had greater physical sequelae than did those with serogroup B disease. Greater cognitive deficits were associated with younger age at diagnosis. Only 53 of 101 case subjects reported any medical follow-up care after invasive meningococcal disease.
Survivors of invasive meningococcal disease in adolescence have a disturbing series of deficits, including poorer physical and mental health, quality of life, and educational achievement. Serogroup C is associated with poorer outcomes. Invasive meningococcal disease attributable to serogroup B disease remains a major cause of morbidity and death among adolescents. Medical care is poor after discharge from the hospital. Routine follow-up care of adolescent survivors may prevent or ameliorate physical and psychosocial morbidity after invasive meningococcal disease.
我们研究了青少年侵袭性脑膜炎球菌病的身体、认知、教育、社会和心理后果，以及与这些后果相关的人口统计学和疾病因素。
进行了一项基于人群的匹配队列研究。来自英格兰6个地区的总共101对性别和年龄匹配的病例对照（疾病发生时年龄为15 - 19岁；46%为男性）在侵袭性脑膜炎球菌病发生后18至36个月接受了随访评估。通过使用标准化问卷和神经心理学测试收集教育、社会和职业功能、心理健康、社会支持、自我效能和生活质量数据。
57%的病例受试者（n = 58）有严重身体后遗症。与对照受试者相比，幸存者有更严重的抑郁症状、更易疲劳、社会支持更少、生活质量下降更明显以及教育程度更低。C群疾病的幸存者比B群疾病的幸存者有更严重的身体后遗症。更大的认知缺陷与诊断时年龄较小有关。101例病例受试者中只有53例报告在侵袭性脑膜炎球菌病后接受了任何医疗随访。
青少年侵袭性脑膜炎球菌病的幸存者存在一系列令人不安的缺陷，包括较差的身心健康、生活质量和教育成就。C群与较差的后果相关。B群疾病导致的侵袭性脑膜炎球菌病仍然是青少年发病和死亡的主要原因。出院后医疗护理较差。对青少年幸存者进行常规随访护理可能预防或改善侵袭性脑膜炎球菌病后的身体和心理社会疾病。
