Long-term neuro-functional disability in adult patients with community-acquired bacterial meningitis.

Autor:	Akroum, Souade, Tubiana, Sarah, de Broucker, Thomas, Dournon, Nathalie, Varon, Emmanuelle, Ploy, Marie Cécile, Mourvillier, Bruno, Oziol, Eric, Lacassin, Flore, Laurichesse, Henri, Hoen, Bruno, Duval, Xavier, Burdet, Charles, and the COMBAT study group, Duval, X, Hoen, B, Mourvillier, B, Varon, E, Tubiana, S, Ploy, M. C.
Předmět:	RESEARCH CONFIDENCE intervals FUNCTIONAL status MULTIVARIATE analysis MULTIPLE regression analysis DISABILITY evaluation BACTERIAL meningitis RISK assessment COMMUNITY-acquired infections DISEASE prevalence DESCRIPTIVE statistics PEOPLE with disabilities ODDS ratio LONGITUDINAL method DISEASE complications ADULTS
Zdroj:	Infection; Oct2022, Vol. 50 Issue 5, p1363-1372, 10p, 1 Diagram, 2 Charts
Abstrakt:	Purpose: To investigate the prevalence of neuro-functional disability and its determinants 12 months after community-acquired bacterial meningitis (CABM) in adult patients. Methods: In a prospective multicenter cohort study (COMBAT), all consecutive cases of CABM were enrolled and followed up for 12 months. Neuro-functional disability at 12 months was evaluated using a combination of the Glasgow Outcome Scale (functional disability), and the modified Rankin Disability Scale (physical disability). Factors associated with neuro-functional disability were identified by multivariate logistic regression. Results: Among 281 patients, 84 (29.9%) patients exhibited neuro-functional disability at 12 months: 79 (28.1%) with functional disability and 51 (18.1%) with physical disability. Overall, 6 patients (2.1%) died during the follow-up. The most common pathogen identified was Streptococcus pneumoniae (131/272, 48.2%); 77/268 patients (28.7%) had a physical disability at hospital discharge. Factors independently associated with 12-month neuro-functional disability were a pneumococcal meningitis (adjusted OR = 2.8; 95% confidence interval (CI) = [1.3; 6.7]), the presence of a physical disability at hospital discharge (aOR = 2.3; 95%CI = [1.2; 4.4]) and the presence of behavioral disorders at hospital-discharge (aOR = 5.9; 95%CI = [1.6; 28.4]). Dexamethasone use was not significantly associated with neuro-functional disability (OR = 0.2; 95%CI = [< 0.1;1.3]). Conclusion: Neuro-functional disability is frequently reported 12 months after CABM. Detailed neurological examination at discharge is needed to improve the follow-up. Trial registration: NCT01730690. [ABSTRACT FROM AUTHOR]
Databáze:	Complementary Index
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