Predictors of long term neurological outcome in bacterial meningitis.

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dc.contributor.authorSinghi, Pratibhaen_US
dc.contributor.authorBansal, Arunen_US
dc.contributor.authorGeeta, Pen_US
dc.contributor.authorSinghi, Suniten_US
dc.date.accessioned2007-04-04en_US
dc.date.accessioned2009-05-30T13:23:51Z
dc.date.available2007-04-04en_US
dc.date.available2009-05-30T13:23:51Z
dc.date.issued2007-04-04en_US
dc.description.abstractOBJECTIVE: To study the long-term neurological and developmental outcome and the clinical and laboratory predictors of sequelae in children with acute bacterial meningitis (ABM). METHODS: Detailed clinical and demographic data was retrieved from the medical records of study children. Subsequently they were followed up for a minimum of 12 months after discharge for development, neurological and hearing assessment. All sequelae were identified and divided into minor or major. For analysis data was divided into 2 groups those with sequelae and without sequelae at follow-up. Statistical analysis was done using SPSS version 10.00 and Epi Info version 2000. RESULTS: 61 boys and 19 girls, a mean age of 31.4 +/= 41.9 months at the time of ABM, were included in the study. Of these 62.5% children were infants. Mean age at follow-up was 58.6 +/= 47.2 months. Sequelae were observed in 32 (40%) children (8 (10%) minor and 24 (30%) major). Mean social quotient at follow-up was 92.8 +/= 32.6. Developmentally 22 (37.9%) children were normal and 20 (34.5%) had global delay. Seizures (P=0.015), cranial nerve palsy (P=0.0065), abnormal deep tendon reflexes (P=0.002), Glasgow coma scale score (GCS) < 8 (P = 0.044) at admission, a CSF culture positive for bacteria and abnormal findings on ultrasonography or computed tomography of head at admission had significant association with sequelae at follow-up. All children (7/7) who had infarct on CT scan (P=0.001) and 12 (80%) of 15 patients who had hydrocephalus (OR - 9.0, 95% CI - 2.03-45.6, P=0.001) diagnosed on CT scan developed severe sequelae. On multiple regressions GCS score <8, presence of cranial nerve palsy and abnormal deep tendon reflexes were independent predictors of sequelae. CONCLUSION: Neurological and audiological sequelae and global developmental delay may be seen in about one third of survivors of bacterial meningitis. GCS score <8, presence of infarct or cranial nerve palsy, or hydrocephalous on CT/ ultrasound at admission may help in identification of children most likely to need long term follow up and rehabilitation.en_US
dc.description.affiliationDepartment of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India.en_US
dc.identifier.citationSinghi P, Bansal A, Geeta P, Singhi S. Predictors of long term neurological outcome in bacterial meningitis. Indian Journal of Pediatrics. 2007 Apr; 74(4): 369-74en_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/81646
dc.language.isoengen_US
dc.source.urihttps://medind.nic.in/icb/icbai.shtmlen_US
dc.subject.meshAcute Diseaseen_US
dc.subject.meshChilden_US
dc.subject.meshChild, Preschoolen_US
dc.subject.meshDevelopmental Disabilities --etiologyen_US
dc.subject.meshFemaleen_US
dc.subject.meshFollow-Up Studiesen_US
dc.subject.meshGlasgow Coma Scaleen_US
dc.subject.meshHumansen_US
dc.subject.meshInfanten_US
dc.subject.meshMaleen_US
dc.subject.meshMeningitis, Bacterial --classificationen_US
dc.subject.meshMeningitis, Pneumococcal --complicationsen_US
dc.subject.meshMental Retardation --etiologyen_US
dc.subject.meshNervous System Diseases --etiologyen_US
dc.subject.meshPrognosisen_US
dc.subject.meshRegression Analysisen_US
dc.subject.meshRisk Factorsen_US
dc.titlePredictors of long term neurological outcome in bacterial meningitis.en_US
dc.typeJournal Articleen_US
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