Prognostic factors and determinants of fatal outcome due to bacterial meningitis in the Lazio region of Italy, 1996–2000
Received 4 August 2005; received in revised form 1 December 2005; accepted 22 December 2005.
Summary
Objectives
To estimate case fatality rates (CFR) of bacterial meningitis and analyze factors associated with mortality due to bacterial meningitis in the Italian region of Lazio.
Methods
Patients reported with bacterial meningitis during the period 1996–2000, who died within 30 days from hospitalization (cases), were compared with survivors (controls) for factors related to healthcare. Age, gender, residence, bacterial agent, co-morbidities, and signs of disease severity were also analyzed in the final model. Healthcare factors were analyzed using current surveillance databases.
Results
Disease severity (OR=8.84; 95% CI=3.35–23.34) and age >44 years (OR=4.59; 95% CI=2.01–10.48) were the risk factors most strongly associated with death, while treatment in an infectious diseases ward was a protective factor, although modified by patient residence and by co-morbidities.
Conclusions
This protective effect was possibly due to differences in treatment protocols between the infectious diseases ward and other wards. The protective effect was found to be stronger for residents of Rome, suggesting delayed access to infectious diseases wards for non-residents. The difference in risk of dying from meningitis at younger ages than that found in other studies should be further evaluated, using information on bacteria serogroups and antibiotic susceptibility.
Corresponding Editor: Michael Whitby, Brisbane, Australia
ABSTRACT