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Predictors of Dzupova et al for Unfavorable Outcome for an Adult with Acute Bacterial Meningitis

Description

Dzupova et al reported factors associated with an unfavorable outcome for an adult with acute bacterial infection. This can help to identify a patient who may benefit from more aggressive management. The authors are from Charles University, Bulovka University Hospital and the National Institute of Public Health in Prague.


Patient selection: adult with acute bacterial meningitis

 

Outcome: Glasgow outcome scale 1 (death) to 4 (moderate disability)

 

Predictors of an unfavorable outcome:

(1) comorbidity (arteriosclerosis, diabetes, alcoholic liver disease, cancer, immunodeficiency, etc)

(2) time to treatment > 48 hours

(3) coma (Glasgow coma scale 8 or less)

(4) hypotension (mean arterial pressure < 60 mm Hg if age <= 50 years or < 65 mm Hg if > 50 years

(5) higher CSF protein in g/L (mean 5.7 g/L, vs 3.0 for favorable)

(6) low glucose ratio (CSF glucose to serum glucose, mean 0.09 vs 0.18 for favorable)

(7) pathogen other than Neisseria meningitidis


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