Risk factors analysis for early fatality in children with acute bacterial meningitis

Ying Chao Chang, Chao Ching Huang, Shan Tair Wang, Ching Chuan Liu, Jing Jane Tsai

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

To identify the cause of early fatality and to delineate the clinical findings on admission associated with this early fatality, a retrospective study of 101 children with bacterial meningitis was performed in southern Taiwan. Risk factors for early fatality are compared between patients with and without acute death in the first 3 days after admission. The overall patient fatality is 27%. Eighty-five percent of them (23 patients) occur at an average of 16.5 hours after admission despite proper antibiotic treatment. The causes of early death are predominantly hemodynamic in 14 patients (61%) and predominantly neurologic in nine (39%). Analysis of clinical parameters available on admission indicated a significant risk of early death in patients who have tachycardia, tachypnea, hypothermia, poor skin perfusion, metabolic acidosis, leukopenia, thrombocytopenia, low cerebrospinal fluid leukocyte count, and high cerebrospinal fluid lactate level. Multivariate analysis demonstrates that metabolic acidosis, poor skin perfusion, and low cerebrospinal fluid leukocyte count are independently and significantly associated with early fatality. In conclusion, two thirds of early fatalities in children with bacterial meningitis are the result of septic shock. Close surveillance for signs of septic shock, as well as of brain herniation should be continued, especially within 3 days after antibiotic treatment.

Original languageEnglish
Pages (from-to)213-217
Number of pages5
JournalPediatric Neurology
Volume18
Issue number3
DOIs
Publication statusPublished - Mar 1998
Externally publishedYes

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Bacterial Meningitides
Statistical Factor Analysis
Cerebrospinal Fluid
Septic Shock
Acidosis
Leukocyte Count
Perfusion
Anti-Bacterial Agents
Tachypnea
Skin
Leukopenia
Hypothermia
Taiwan
Tachycardia
Thrombocytopenia
Nervous System
Cause of Death
Lactic Acid
Multivariate Analysis
Retrospective Studies

ASJC Scopus subject areas

  • Clinical Neurology
  • Pediatrics, Perinatology, and Child Health
  • Developmental Neuroscience
  • Neurology

Cite this

Risk factors analysis for early fatality in children with acute bacterial meningitis. / Chang, Ying Chao; Huang, Chao Ching; Wang, Shan Tair; Liu, Ching Chuan; Tsai, Jing Jane.

In: Pediatric Neurology, Vol. 18, No. 3, 03.1998, p. 213-217.

Research output: Contribution to journalArticle

Chang, Ying Chao ; Huang, Chao Ching ; Wang, Shan Tair ; Liu, Ching Chuan ; Tsai, Jing Jane. / Risk factors analysis for early fatality in children with acute bacterial meningitis. In: Pediatric Neurology. 1998 ; Vol. 18, No. 3. pp. 213-217.
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