Neurosciences Centre, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110 029, India.
Neurocrit Care. 2010 Oct;13(2):199-204. doi: 10.1007/s12028-010-9396-4.
Clinical recognition of acute bacterial meningitis (ABM) and its early prognostication would guide the degree of intensive treatment required. We aimed to study the clinical features and factors associated with death in patients with community acquired ABM.
Adult patients with clinically suspected community acquired ABM (CAABM) were studied between July 2004 to September 2008 (retrospective and prospective). Detailed history, clinical examination, cerebrospinal fluid (CSF) analysis, and laboratory investigations were performed and noted. The complications with which the patient presented or developed during hospital course were also noted. The outcome noted was at the time of discharge.
In multivariate logistic regression, independent factors associated with death were rural area of residence, presentation after >24 h, total leukocyte count (TLC) of <15000, CSF neutrophils <75%, low GCS at the time of admission, and a high creatinine level.
In the present study, most of the factors predicting death were identified at the time of admission. Identification of these factors could help prioritizing patients needing intensive care facilities, especially in resource poor setting.
临床对急性细菌性脑膜炎（ABM）的识别及其早期预后判断可指导所需强化治疗的程度。我们旨在研究社区获得性 ABM 患者的临床特征和与死亡相关的因素。
2004 年 7 月至 2008 年 9 月（回顾性和前瞻性）研究了临床上疑似患有社区获得性 ABM（CAABM）的成年患者。详细记录病史、临床检查、脑脊液（CSF）分析和实验室检查。还记录了患者在住院期间出现或发展的并发症。出院时记录了患者的结局。
在多变量逻辑回归中，与死亡相关的独立因素包括居住在农村地区、发病时间>24 小时、白细胞总数（TLC）<15000、CSF 中性粒细胞<75%、入院时 GCS 评分低和肌酐水平高。
在本研究中，大多数预测死亡的因素是在入院时确定的。识别这些因素可以帮助确定需要重症监护设施的患者的优先级，特别是在资源匮乏的环境中。
