Clinical Characteristics and Predictors of Mortality of Patients with Post-Neurosurgical Meningitis-A 900-Cases Cohort Study.

Abstract

Aim: To express the clinical characteristics of patients with post-neurosurgical meningitis (PNM) and launch a survival analysis to screen mortality predictors.

Methods: A cohort analysis containing more than 70000 patients was evaluated, and all of them received neurosurgical procedure. Clinical and microbial epidemiology, therapy and mortality of PNM patients were reviewed. Multi-variable Cox proportional hazard models were applied to achieve survival analysis.

Results: About 900 PNM patients from 3244 cases were selected for characteristics and survival analysis, the mean age of them was 41 (27-54) years, 516 (57.3%) were men and 384 (42.7%) were women. The 28-day mortality was 12.4% (112 of 900) in patients with PNM. Hypertension, external ventricular drainage (EVD), and lumbar drainage (LD) are mortality predictors for PNM, with a hazard ratio (HR) of 2.641 (95% C.I. 1.563-4.464, P<0.001), 2.196 (95% C.I. 1.317-3.662, P=0.003), and 1.818 (95% C.I. 1.126-2.936, P=0.014). In treatment, the outcome of patients receiving three or more antibiotic combinations is better than that of patients receiving dual-drug combinations.

Conclusion: The mortality of patients with PNM was relatively high, and the risk factors related to 28-days mortality were hypertension, EVD and LD and treatment with three or more antibiotics are much better.