Lodder M C, Schildkamp R L, Bijlmer H A, Dankert J, Kuik D J, Scholten R J
Institute for Research in Extramural Medicine, Vrije Universiteit, Amsterdam, The Netherlands.
J Med Microbiol. 1996 Jul;45(1):16-20. doi: 10.1099/00222615-45-1-16.
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 chi2 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 > or = 50 years, in female patients and in patients presenting with coma, temperature < or = 38.0 degrees C, mean arterial pressure < or = 70 mmHg, white blood cell count < or = 10 x 10(9)/L and platelet count < or = 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.
为评估脑膜炎球菌病患者死亡结局的预后指标，我们通过负责医生填写的问卷，前瞻性收集了1989年4月1日至1990年4月30日期间荷兰报告的562例经培养证实的脑膜炎球菌病患者的数据。采用卡方检验和多因素logistic回归进行分析。在研究期间，43例患者（7.7%）死亡。0至5个月、10至19岁以及≥50岁的患者、女性患者，以及出现昏迷、体温≤38.0℃、平均动脉压≤70mmHg、白细胞计数≤10×10⁹/L和血小板计数≤100×10⁹/L的患者死亡风险增加。易感因素和入院前疾病持续时间与结局显著相关，但在多因素分析中这些关联消失。种族、入院前使用抗生素、癫痫发作和出血性皮肤病变与结局无关。总之，年龄、性别、昏迷、体温、平均动脉压、白细胞计数和血小板计数是脑膜炎球菌病结局的独立预后指标。对这些特征的评估可能有助于识别高危患者，将其迅速转入重症监护病房可能改善其预后。
