Table 3.
Factors associated with mortality and neurological impairment due to community-acquired bacterial meningitis including time to antibiotics by logistic regression.
| Mortality | Neurological impairment | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Total | Alive | Dead | Odds ratio (95% CI) | Total | Alive | Dead | Odds ratio (95% CI) | |||
| Univariate | Multivariable | Univariate | Multivariable | |||||||
| Number of patientsa | 659 (100%) | 517 (78.6%) | 142 (21.6%) | n = 466 | 485 (100%) | 328 (67.6%) | 157 (32.4%) | n = 353 | ||
| Time to antibiotics, hb,c | 2.0 (0.9–6.0) | 1.8 (0.8–4.5) | 4.5 (1.5–18.0) | 1.0 (1.0–1.1) | 1·1 (1·0–1·1) | 1.8 (0.9–4.9) | 1.8 (0.8–4.2) | 2.3 (1.0–6.8) | 1.0 (1.0–1.1) | 1.0 (1.0–1.1) |
| > 1 h (vs < 1 h)a | 461 (74.1) | 356 (77.4) | 105 (22.6) | 1.8 (1.1–2.9) | 337 (73.1) | 220 (65.3) | 117 (34.7) | 1.4 (0.9–2.1) | ||
| > 2 h (vs < 2 h)a | 328 (52.7) | 236 (72.2) | 92 (27.8) | 2.8 (1.8–4.2) | 226 (49.0) | 146 (64.6) | 80 (35.4) | 1.2 (0.8–1.8) | ||
| > 3 h (vs < 3 h)a | 258 (41.5) | 177 (68.9) | 81 (31.1) | 3.1 (2.0–4.6) | 172 (37.3) | 105 (61.1) | 67 (38.9) | 1.5 (1.0–2.3) | ||
| > 4 h (vs < 4 h)a | 214 (34.4) | 142 (66.7) | 72 (33.4) | 3.1 (2.1–4.7) | 140 (30.4) | 84 (60.0) | 56 (40.0) | 1.6 (1.0–2.4) | ||
| > 5 h (vs < 5 h)a | 178 (28.6) | 116 (65.5) | 62 (34.8) | 3.0 (2.0–4.5) | 115 (25.0) | 67 (58.3) | 48 (41.7) | 1.7 (1.1–2.6) | ||
| Age, yearsc | 55 (34–69) | 52 (28–64) | 69 (55–78) | 1.1 (1.0–1.1) | 1·0 (1·0–1·1) | 53 (29–64) | 49 (22–63) | 59 (49–68) | 1.0 (1.0–1.0) | 1.0 (1.0–1.1) |
| Femalea | 279 (50.4) | 201 (72.3) | 78 (28.1) | Ref | 184 (48.5) | 68 (37.0) | 116 (63.0) | Ref | ||
| Malea | 274 (49.6) | 219 (79.9) | 55 (20.1) | 0.7 (0.4–0.9) | 195 (51.5) | 67 (34.4) | 128 (65.6) | 0.9 (0.6–1.4) | ||
| Impaired consciousnessd | 347 (62.6) | 244 (70.5) | 103 (29.7) | 2.5 (1.6–3.9) | 2·6 (1·4–4·6) | 219 (57.8) | 99 (45.2) | 120 (54.8) | 2.8 (1.8–4.5) | 2.1 (1.1–3.7) |
| Comorbiditya,e | 182 (35.2) | 126 (69.6) | 56 (30.8) | 1.6 (1.1–2.5) | 1·7 (1·0–2·7) | 124 (32.7) | 55 (44.4) | 69 (55.7) | 1.7 (1.1–2.7) | 1.7 (1.0–2.8) |
| Steroid therapya | 232 (43.3) | 191 (82.7) | 41 (17.7) | 0.5 (0.4–0.8) | 170 (46.0) | 42 (24.7) | 128 (75.3) | 0.4 (0.3–0.7) | 0.4 (0.3–0.8) | |
| Infecting pathogenf | ||||||||||
| N. meningitidis a | 110 (20.0) | 103 (93.6) | 7 (6.4) | Ref | 82 (21.6) | 67 (81.7) | 15 (18.3) | Ref | ||
| S. pneumoniaea | 295 (53.5) | 221 (74.9) | 74 (25.1) | 4.9 (2.2–11.1) | 203 (53.56) | 116 (57.1) | 87 (42.9) | 3.4 (1.8–6.3) | ||
| S. aureus a | 26 (4.7) | 10 (38.5) | 16 (61.5) | 23.5 (7.8–70.7) | 10 (2.6) | 3 (30.0) | 7 (70.0) | 10.4 (2.4–45.0) | ||
| H. influenzae a | 20 (3.6) | 18 (90.00) | 2 (10.00) | 1.6 (0.3–8.5) | 17 (4.5) | 16 (94.1) | 1 (5.9) | 0.3 (0.0–2.3) | ||
| Others a,h | 77 (14.0) | 49 (63.6) | 28 (36.4) | 8.4 (3.4–20.6) | 48 (12.7) | 31 (64.6) | 17 (35.4) | 2.4 (1.1–5.5) | ||
| Other gram negative a,g | 23 (4.2) | 19 (82.6) | 4 (17.4) | 3.1 (0.8–11.6) | 19 (5.0) | 11 (57.9) | 8 (42.1) | 3.2 (1.1–9.5) | ||
aNumber (%).
bMissing data in 37 patients.
cMedian (interquartile range).
dImpaired consciousness at hospital presentation.
eComorbidities include diabetes, cancer, alcoholism, kidney failure and HIV.
fMissing data in 107.
gIncludes E· coli, K. pneumonia, P. multocida, Capnocytophaga spp.
hIncludes Streptococcus spp, E. faecalis, L. monocytogenes.