Clinical features, laboratory data, management and the risk factors that affect the mortality in patients with postoperative meningitis.

ABSTRACT

BACKGROUND: Nosocomial meningitis is a rare complication following neurosurgical procedures and is associated with high morbidity and mortality. AIM: The aim of this study was to describe the clinical characteristics and the risk factors associated with mortality in patients who developed nosocomial meningitis following neurosurgical operations. SETTING AND DESIGN: Tertiary care hospital and an observational study. MATERIALS AND METHODS: The study subjects included 2265 patients who underwent various neurosurgical operations during 2003-05. The diagnosis of nosocomial meningitis was based on the Center for Disease Control criteria. STATISTICAL ANALYSIS: It was performed by using Statistical Package for Social Sciences for Windows 10.0 program. RESULTS: The incidence of postoperative nosocomial meningitis was 2.7% (62 episodes in 49 patients among 2265 patients operated). Staphylococcus aureus and Acinetobacter spp. were the most frequently isolated pathogens. Of the 49 with meningitis 20 (40.8%) patients died. In the logistic regression analysis model, Glascow coma scale score less than 10 (Odds Ratio (OR) 19.419, 95% Confidence Interval (CI); 1.637-230.41, P = 0.001), and low cerebrospinal fluid glucose level (< or = 30 mg/ dL) (OR 10.272, 95% CI; 1.273-82.854, P = 0.002), and presence of concurrent nosocomial infection (OR 28.744, 95% CI;1.647-501.73, P =0.001) were the independent risk factors associated with mortality. CONCLUSION: The mortality in patients who developed meningitis was high. The high percentage of concurrent nosocomial infections was associated with a high mortality rate which was a serious problem.