Liu Ying, Feng Yu, Guo YanPing, Chen JingJing, Liu Chang, Liang JiaBi
Department of Pediatrics, Peking University Shenzhen Hospital, Shenzhen, China.
Front Pediatr. 2024 Sep 19;12:1414778. doi: 10.3389/fped.2024.1414778. eCollection 2024.
bacterial meningitis (BM) is more common in infants than at any other time in life and remains a devastating disease with considerable risk of death and morbidity. This article aims to gather the currently available evidence to perform a systematic review of clinical factors that may predict or be associated with BM death and/or sequelae in infants < 90 days of age.
The Medline/PubMed, Cochrane Library and Embase databases were systematically searched for prognostic studies that described risk factors for mortality and sequelae in infants aged <90d with BM. The databases were searched from the beginning of the database to December 31st, 2022.The quality of cohort studies was assessed by the Newcastle-Ottawa Scale (NOS). The quality of cross-section studies was assessed by the Agency for Healthcare Research and Quality (AHRQ). A systematic review was undertaken to ascertain the prognostic factors proven to be noteworthy.
Of the 1,431 studies retrieved, 20 were eligible for the final analysis including 11 cohort and 9 cross-sectional studies were identified. Four risk factors predicting poor outcome were mentioned mostly in those studies, including prematurity or low birth weight (LBW), seizures, coma, and elevated CSF protein. But only preterm, coma and elevated CSF protein were identified by multivariate analyses in more than one study.
This study demonstrates several potential predictive factors to the poor outcomes of BM in infant. But with large heterogeneity, these predictors should be evaluated by further well-designed prospective studies.
https://www.crd.york.ac.uk/, identifier CRD42017074949.
细菌性脑膜炎（BM）在婴儿中比在生命中的任何其他时期都更常见，并且仍然是一种具有相当高死亡和发病风险的毁灭性疾病。本文旨在收集当前可用的证据，对可能预测90日龄以下婴儿BM死亡和/或后遗症或与之相关的临床因素进行系统评价。
系统检索Medline/PubMed、Cochrane图书馆和Embase数据库，查找描述90日龄以下患有BM的婴儿死亡率和后遗症危险因素的预后研究。检索时间从各数据库建库起始至2022年12月31日。队列研究的质量采用纽卡斯尔-渥太华量表（NOS）进行评估。横断面研究的质量采用医疗保健研究与质量机构（AHRQ）的标准进行评估。进行系统评价以确定已被证明值得关注的预后因素。
在检索到的1431项研究中，20项符合最终分析的条件，包括11项队列研究和9项横断面研究。这些研究中大多提到了4个预测不良结局的危险因素，包括早产或低出生体重（LBW）、惊厥、昏迷和脑脊液蛋白升高。但在多项研究中，只有早产、昏迷和脑脊液蛋白升高通过多变量分析得以确定。
本研究证实了婴儿BM不良结局的几个潜在预测因素。但由于存在较大异质性，这些预测因素应通过进一步精心设计的前瞻性研究进行评估。
