Prognostic factors in acute bacterial meningitis in children. A case control study Factores pronósticos en meningitis bacteriana aguda en niños. Estudio caso-control

Abstract

Background: The prognosis of acute bacterial meningitis continues to be poor in our country. Previous studies suggest that the delay in diagnosis has an important prognostic value. Aim: To study the influence of diagnosis timing and the clinical conditions of children with acute bacterial meningitis on admission on death and incidence of gross sequelae. Patients and methods: Charts of children deceased or discharged with gross sequelae as consequence of an acute bacterial meningitis were selected. To each of these cases, 4 children with the same diagnosis but discharged in good conditions were selected as controls. Variables recorded were time and number of visits previous to the diagnosis, etiology of meningitis, neurological, respiratory, digestive and hemodynamic involvement on admission. Results: Fifty seven cases and 224 controls were studied. Most cases were 12 months old or less (OR 4.1, 95% CI= 1.97-8.7). Diagnosis made on the first visit or within the first 24 hours of disease