Importance of scoring systems in prognosticating meningococcemia

ABSTRACT

Meningococcal diseases occur with a worldwide distribution as endemic or in epidemics with an overall mortality rate of 8% to 10%, mainly in patients with signs and symptoms of meningococcemia. Several investigators have devised scoring systems using clinical and laboratory parameters available at the time of presentation to prognosticate the outcome of the infection. This study was designed to determine the distribution of demographic, clinical and laboratory parameters among our patients and the relative frequency of individual Stiehm and Damrosch components. This was a prospective descriptive study, performed on patients with definite diagnosis of meningococcal infection admitted to Al-Zahra University hospital [adult and pediatric wards], Isfahan, Iran, between 1997 and 2002. The cases were 140 patients [99[70.7%] males and 41[29.3%]females] from 1 to 50 years old [25.5 +/- 1.32]. Data were collected by filling checklists. SSPS software was applied to analyze the data using chi-square test. In this study, the relative frequency of individual Stiehm and Damrosch components were as follows hypotension [10.7%], peripheral white blood cell count <10,000/mm3 [39.3%], leukopenia [11.5%], ESR<10 mm/hr [19.3%], coma [6.4%], early widespread petechiae [18%], absence of meningitis [13.6%]. Overall mortality rate was [10.7%]. Meningococci are still killers, they affect men more than women. Teenagers are at more risk than other age groups. Mortality in our study was a little higher than what is suggested [10.7%]. we recommend using scoring systems for early separation of poor prognostic patients to provide them with more special care