RISK FACTORS FOR MORTALITY AND SHORT TERM MORBIDITY IN BACTERIAL MENINGITIS AMONG CHILDREN AGED 1 MONTH TO 12 YEARS ADMITTED IN AN URBAN REFERRAL CENTRE
Dr. V.P.KARTHIKEYAN*, Dr. V. PRAKASH**, Dr. S.K.MOHAMMED MUBARAK***, Dr. NEDUNCHELIAN****, Dr. MALLIKA PADMANABHAN*****, Dr. MANGAYARKARASI SENGUTTUVAN ******
Director & Superintendent Institute of Child Health & Hospital for Children, Egmore, Chennai - 8. *, Director & Superintendent Institute of Child Health & Hospital for Children, Egmore, Chennai - 8.**, Director & Superintendent Institute of Child Health & Hospital for Children, Egmore, Chennai - 8. ***, Director & Superintendent Institute of Child Health & Hospital for Children, Egmore, Chennai - 8. ****, Director & Superintendent Institute of Child Health & Hospital for Children, Egmore, Chennai - 8.*****, Director & Superintendent Institute of Child Health & Hospital for Children, Egmore, Chennai - 8. ******
Objectives
To analyze the correlation of risk factors with mortality and short-term morbidity in bacterial meningitis among children aged 1 month to 12 years admitted in an urban referral center.
Design
Nested case controls study. Setting: Institute of Child Health & Hospital for Children.
Methods
The case records of children aged 1 month - 12 years admitted during the 2 year period of Jan 2002-Dec 2003 were taken up for analysis. They were divided into cases and controls. Cases were proven bacterial meningitis with sequelae or had died. Controls were proven bacterial meningitis who had recovered without sequelae. Various risk factors were considered.
Statistical Analysis
They were analyzed by subjecting them to univariate analysis and the risk factors which were significant in the same was subjected to multivariate analysis by logistic regression and the adjusted odds ratios with 95% confidence intervals were arrived.
Results
We have found fever of more than 1 week duration before diagnosis [OR3.5 (95% CI: 1.11-11.32)] CSF protein more than 500 mg/dL [OR19 (95% CI:2.91-127.55)] and admission to ICU [OR5.8 (95% CI:1.67-20.69)] to be the most significant risk factors independently contributing to mortality and immediate sequelae.
Conclusion
The presence of above three factors in children with bacterial meningitis portends a poor outcome stressing the need for aggressive treatment strategy in these subset of children.
Keywords
Bacterial meningitis, Outcome, Risk factors
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V.P.KARTHIKEYAN D, PRAKASH V D, MUBARAK S D, NEDUNCHELIAN D, PADMANABHAN M D, SENGUTTUVAN M D.. Available From : http://www.pediatriconcall.com/fordoctor/ Conference_abstracts/report.aspx?reportid=31
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