Coagulation, coma, and outcome in bacterial meningitis--an observational study of 38 adult cases
| Autor: | Maciej Michał Kowalik, Maria Hlebowicz, H. Trocha, Robert Pajuro, Tomasz Smiatacz |
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| Rok vydání: | 2006 |
| Předmět: |
Microbiology (medical)
Adult Male medicine.medical_specialty Glasgow Outcome Scale Neurological disorder Gastroenterology Meningitis Bacterial Internal medicine Epidemiology medicine Humans Glasgow Coma Scale Coma APACHE Disseminated intravascular coagulation Prothrombin time medicine.diagnostic_test business.industry Acute Kidney Injury Disseminated Intravascular Coagulation Middle Aged medicine.disease Surgery Anti-Bacterial Agents Infectious Diseases Logistic Models Female medicine.symptom business Meningitis |
| Zdroj: | The Journal of infection. 55(2) |
| ISSN: | 1532-2742 |
| Popis: | The purpose of this study was to evaluate the epidemiology of intravascular coagulation in bacterial meningitis and to recognise the associations with disease severity and outcome.Thirty-eight consecutively admitted adult patients with microbiologically proven bacterial meningitis were observed prospectively for platelets count (PLT), platelets-decline (dPLT), prothrombin ratio (PTr), INR, and D-dimer levels during the first three days in relation to disease severity (Glasgow Coma Scale--GCS, APACHE-III) and outcome (Glasgow Outcome Scale--GOS).The prevalence of activated coagulation measured by abnormal laboratory results varied respectively: PTr--30%, INR--36%, PLT--38%, dPLT--50%, and D-dimer--88%. Patients with GCS9 at admission presented with laboratory results suggesting triggered coagulation: dPLT 48 vs. 15%/day (p=0.0246), INR 1.6 vs. 1.12 (p=0.0014), PTr 76 vs. 93% (p=0.0020). An unfavourable outcome (GOS 1-4) was observed in 42% of patients and was associated with: PLT170 or265 G/L (OR--24.4; p=0.0006), PTr82% (OR--5.00; p=0.0388), INR1.1 (OR--5.04; 0.0336), and D-dimer850 ng/ml (OR--24.0; p=0.0033).Coagulation was activated in a majority of patients with bacterial meningitis and related to coma and unfavourable outcome. |
| Databáze: | OpenAIRE |
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