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Table 3 Prognostic clinical parameters for fatal outcome# due to S. pneumoniae meningitis

From: Clinical presentation and prognostic factors of Streptococcus pneumoniae meningitis according to the focus of infection

   

Univariat analysis

 

Multivariate

 

% or median (25/75 percentiles) and (No/total)

Non-survivors N = 41

Survivors N = 146

OR¤

P-value

OR¤

P-value

Sex (female)

51% (21/41)

48% (70/146)

1.14 (0.57–2.28)

0.71

  

Age (in years)

67 (56–74)

50 (1–67)

1.036 (1.02–1.06)

<0.001

1.03 (1.00–1.07)

0.05

Age ≤ 16 years

2% (1/41)

30% (44/146)

0.06 (0.008–0.44)

0.006

0.36 (0.02–7.13)

0.50

Predisposing condition*

10% (4/40)

13% (19/145)

0.74 (0.24–2.30)

0.60

  

Underlying disease§

30% (12/40)

15% (21/145)

2.53 (1.12–5.74)

0.03

1.72 (0.58–5.08)

0.33

Admission during the first half of the year

83% (34/41)

68% (99/146)

2.30 (0.95–5.58)

0.06

1.27 (0.41–3.97)

0.68

Fever

95% (35/37)

97% (125/129)

0.56 (0.10–3.19)

0.61

  

History of headache

62% (13/21)

38% (35/95)

2.79 (1.05–7.38)

0.04

  

Back rigidity

55% (16/29)

57% (70/122)

0.91 (0.40–2.07)

0.84

  

Decreased consciousness

98% (40/41)

93% (125/135)

3.20 (0.40–25.8)

0.46

  

Convulsion

53% (19/36)

25% (35/139)

2.32 (1.07–5.04)

0.03

4.53 (1.74–11.8)

0.002

Mechanical ventilation&

90% (35/39)

48% (62/129)

9.45 (3.18–28.1)

<0.001

  

CT-scan preceding lumbar puncture

22% (9/41)

8% (12/146)

3.14 (1.22–8.01)

0.02

2.62 (0.82–8.41)

0.11

Steroid therapy

9% (3/32)

18% (23/131)

0.49 (0.14–1.73)

0.27

  

Bacteraemia

78% (31/40)

64% (93/146)

1.96 (0.87–4.43)

0.11

2.02 (0.70–5.84)

0.19

Otogenic focus

10% (4/41)

36% (53/146)

0.19 (0.06–0.56)

0.003

0.16 (0.05–0.57)

0.005

Lung focus

39% (16/41)

17% (25/146)

3.10 (1.45–6.63)

0.004

1.46 (0.53–3.97)

0.46

CSF WBC (109 cells/L)

0.32 (0.07–3.1) (33/41)

11 (0.7–4.7) (116/146)

0.88 (0.77–1.01)

0.06

  

500 cells/μL

55% (18/33)

22% (26/116)

4.15 (1.84–9.36)

0.001

  

CSF protein (g/L)

4.7 (2.7–8.9) (27/41)

2.4 (1.3–4.8) (96/146)

1.19 (1.07–1.33)

0.001

  

CSF glucose (mmol/L)

0.4 (0.1–1.6) (29/41)

1.0 (0.4–3.1) (100/146)

0.83 (0.63–1.08)

0.17

  

<1 mmol/L

76% (22/29)

52% (52/100)

3.41 (1.33–8.69)

0.01

  

CSF/blood glucose ratio

0.05 (0.01–0.11) (21/41)

0.18 (0.06–0.5) (72/146)

0.01 (0.00–0.36)

0.01

  

Blood WBC (109 cells/L)

14.8 (9.5–24.1) (28/41)

17.7 (10.8–26.8) (106/146)

0.98 (0.94–1.02)

0.34

  
  1. # Within 100 days after admission.
  2. ¤ OR was calculated per additional units for continuous data.
  3. * Predisposing condition was defined a previous head trauma, liquorrhoea, dura disruption etc.
  4. §Underlying disease was defined as previous splenectomy, presence of immunodeficit, cancer, diabetes mellitus, alcoholism, or the use of immunosuppressive drugs.
  5. & If need for assisted ventilation was included in the multivariate analysis convulsions, absence of otogenic focus, and need for assisted ventilation were of significant importance for fatal outcome (p < 0.05, data not shown).
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BMC Infectious Diseases

ISSN: 1471-2334

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