Meningite meningocócica: características clínicas e laboratoriais, taxa de letalidade e variáveis associadas com mortalidade intra-hospitalar
| Autor: | Vanessa L. Strelow, José E. Vidal, Karin R. Kolbe, Érique José F. Peixoto de Miranda, Juliana Valéria de Souza Framil, Augusto César Penalva de Oliveira |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Male medicine.medical_specialty Pediatrics Adolescent Neisseria meningitidis medicine.disease_cause lcsh:RC321-571 Tertiary Care Centers Young Adult 03 medical and health sciences 0302 clinical medicine Seizures Tachycardia Case fatality rate Epidemiology medicine Humans Hospital Mortality 030212 general & internal medicine epidemiologia Young adult Child Pleocytosis lcsh:Neurosciences. Biological psychiatry. Neuropsychiatry Neck stiffness meningitis meningococcal Retrospective Studies business.industry Age Factors Retrospective cohort study Middle Aged medicine.disease meningite meningocócica Neurology Child Preschool Female epidemiology Neurology (clinical) Hypotension business Meningitis Brazil 030217 neurology & neurosurgery |
| Zdroj: | Arquivos de Neuro-Psiquiatria, Volume: 74, Issue: 11, Pages: 875-880, Published: NOV 2016 Arquivos de Neuro-Psiquiatria, Vol 74, Iss 11, Pp 875-880 Arquivos de Neuro-Psiquiatria v.74 n.11 2016 Arquivos de neuro-psiquiatria Academia Brasileira de Neurologia instacron:ABNEURO |
| ISSN: | 0004-282X |
| DOI: | 10.1590/0004-282x20160143 |
| Popis: | Meningococcal meningitis is a public health problem. The aim of this study was to describe the clinical characteristics of patients with meningococcal meningitis, and to identify associated factors with mortality. This was a retrospective study, between 2006 and 2011, at a referral center in São Paulo, Brazil. Logistic regression analysis was used to identify factors associated with mortality. We included 316 patients. The median age was 16 years (IQR: 7–27) and 60% were male. The clinical triad: fever, headache and neck stiffness was observed in 89% of the patients. The cerebrospinal triad: pleocytosis, elevated protein levels and low glucose levels was present in 79% of patients. Factors associated with mortality in the multivariate model were age above 50 years, seizures, tachycardia, hypotension and neck stiffness. The classic clinical and laboratory triads of meningococcal meningitis were variable. The fatality rate was low. Age, seizures and shock signs were independently associated with mortality. RESUMO Meningite meningocócica (MM) é um problema de saúde pública. Os objetivos deste estudo foram descrever características clinicas de pacientes com MM, e identificar fatores associados à mortalidade intra-hospitalar. Trata-se de um estudo retrospectivo, entre 2006 e 2011, em um centro de referência, São Paulo, Brasil. Análise de regressão logística multivariada foi usada para identificar fatores associados na admissão com mortalidade intra-hospitalar. Foram incluídos 316 casos. A média de idade foi 16 anos (IQR: 7–27) e 189 (60%) eram do sexo masculino. A tríade clínica: febre, cefaléia e rigidez de nuca foi observada em 89% dos casos. A tríade do exame de líquor: pleocitose, proteinorraquia elevada e hipoglicorraquia ocorreu em 79% dos casos. Fatores associados à mortalidade no modelo multivariado foram: idade acima de 50 anos, convulsões, taquicardia, hipotensão e rigidez de nuca. Tríades clínicas e laboratoriais clássicas de MM foram variáveis. Na admissão, idade, convulsões, taquicardia e hipotensão associaram-se independentemente com o desfecho. |
| Databáze: | OpenAIRE |
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