Hospital Universitário Oswaldo Cruz, Universidade de Pernambuco (UPE), Recife, PE, Brazil.
Braz J Infect Dis. 2013 Sep-Oct;17(5):538-44. doi: 10.1016/j.bjid.2013.01.016. Epub 2013 Jul 5.
This was a case-control study to identify prognostic indicators of bacterial meningitis in a reference hospital in Pernambuco/Brazil. The data were collected from charts of 294 patients with bacterial meningitis between January 2000 and December 2004. Variables were grouped in biological, clinical, laboratory and etiologic agent/treatment. Variables selected in each step were grouped and adjusted for age. Two models were created: one containing clinical variables (clinical model) and other containing laboratory variables (laboratory model). In the clinical model the variables associated with death due to bacterial meningitis were dyspnea (p=0.006), evidence of shock (p=0.051), evidence of altered mental state (p=0.000), absence of headache (p=0.008), absence of vomiting (p=0.052), and age ≥40 years old (p=0.013). In the laboratory model, the variables associated with death due to bacterial meningitis were positive blood cultures (p=0.073) and thrombocytopenia (p=0.019). Identification of prognostic indicators soon after admission may allow early specific measures, like admission of patients with higher risk of death to Intensive Care Units.
这是一项病例对照研究，旨在确定巴西伯南布哥州一家参考医院中细菌性脑膜炎的预后指标。该研究的数据来自 2000 年 1 月至 2004 年 12 月期间 294 名细菌性脑膜炎患者的病历。将变量分为生物学、临床、实验室和病原体/治疗因素。在每个步骤中选择的变量进行分组，并按年龄进行调整。创建了两个模型：一个包含临床变量（临床模型），另一个包含实验室变量（实验室模型）。在临床模型中，与细菌性脑膜炎死亡相关的变量包括呼吸困难（p=0.006）、休克证据（p=0.051）、精神状态改变的证据（p=0.000）、头痛缺失（p=0.008）、呕吐缺失（p=0.052）和年龄≥40 岁（p=0.013）。在实验室模型中，与细菌性脑膜炎死亡相关的变量包括血培养阳性（p=0.073）和血小板减少症（p=0.019）。在入院后不久识别预后指标，可能有助于早期采取特定措施，例如将死亡风险较高的患者收入重症监护病房。
