Meningites Bacterianas Agudas em crianças e adolescentes: Fatores de risco para óbito ou seqüelas precoces
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2005-11-26
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Universidade Federal de Goiás
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Objetive: To identify possible risk factors associate with poor prognosis among children and teenagers with acute bacterial meningitis Methods: Prevalence study with casecontrol
analysis by review of medical records of patients aged 1 month to 19 years admitted to Tropical Disease Hospital in Goiânia Goiás with acute bacterial meningitis from 1 january 1998 to 31 december 2001 Patients who died or had one or more neurological sequelae at discharge were cosidered cases and patients with the same diagnosis but discharged with healthy recoveries as controls Risk factors for adverse
outcome such as age sex proceeding area period between onset of symptoms and hospital admission history of antibiotic use etiologic agent meningeous signs level of consciousness convulsion circulatory and respiratory distress and laboratory values including peripheral white blood cels counts cerebrospinal fluid (CSF) protein level CSF glucose level and CSF white blood cels count were analysed Univariate analysis and logistics regression was used to evaluate the association between death or neurologic sequelae (depedents variables) and each risk factors (independent variable) Results: Of
the 409 children and 117 teenagers admitted during the period of study 430 discharged with healthy recoveries 43 (8,2%) died and 53 (10,1%) had at least one sequelae at
discharge (motor deficit, seizure hydrocephalus hearing impairment, cranial nerve deficits cerebral palsy and ataxia) Age < 24 months circulatory and respiratory distress torpor or coma seizure absence of meningeous signs proceeding area and peripheral white blood cels count < 5000/ mm³ were associated with poor prognosis However, age <24 months respiratory distress and torpor or coma were independently associated with adverse outcome Conclusion: Age < 24 months respiratory distress and torpor or coma were the main risk factors independently associated with poor prognosis Early
identification of the all risk factors is very important to select the patients who need special care during of stay in hospital and after discharge at least until school age
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NEVES, Jane Marcia Brito das. Meningites Bacterianas Agudas em crianças e adolescentes:
Fatores de risco para óbito ou seqüelas precoces. 2005. 70 f. Dissertação (Mestrado em Medicina) - Universidade Federal de Goiás, Goiânia, 2005.