Analysis On Risk Factors For Poor Prognosis Of Children’s Bacterial Meningitis On Children Hospital

Objectives To describe the clinical features of bacterial meningitis, and explore the risk factors for its poor prognosis by retrospectively analyzing the data of 160 children inpatient cases of bacterial meningitis in our hospital.Methods Data of 160 inpatients with children bacterial meningitis were collected, who were hospitalized from February 1, 2009 to December 31, 2013 in our hospital. All cases met the diagnostic criteria of bacterial meningitis. They were divided into two groups according to their prognosis. Group A consisted of 91 cases of good prognosis; group B 69 cases of poor prognosis. All data included medical history, physical examination, routine lumbar puncture cerebrospinal fluid examination(CSF examination results for the first time on admission),and routine blood., as well as CRP, serum biochemistry, blood culture, Lymphocyte subsets+ CD64, procalcitonin combination, and routine examinations of blood, urine and stool. Homemade information collection form was used to collect the basic information of all the cases, birth-related data, the past history, family history, clinical symptoms and signs, physical examination, complications, clinical outcomes, laboratory and ancillary test result and other relevant information. SPSS 11.5 statistical software was used for statistical analysis. First univariate analysis was conducted to screen reliable variables, and then multivariate logistic regression was used to determine the risk factors for poor prognosis of children’s bacterial meningitis.Results In this study, ages of onset of 160 children with bacterial meningitis were mainly within 0-3years old, and most of them came from rural and suburban.Univariate analysis showed that average onset age, family income in group B were lower than group A(P<0.05); the proportion of children from rural and peri-urban in group B were higher than that of group A(P<0.05); histories of otitis compared between the two groups revealed that otitis was common in group B than in group A(P<0.05); percentage of onset to start of treatment time longer than three days was higher in B group than group A(P<0.05).Unconsciousness, convulsions, subdural effusion, hydrocephalus, ependymitis, cerebral infarction, brain abscess, shock in group B was significantly higher than in group A(P<0.05). Cerebrospinal fluid nucleated cell count, cerebrospinal fluid chloride content, CD64, CRP, procalcitonin, blood/cerebrospinal fluid culture positive showed no significant difference between the two groups(P> 0.05). CSF protein content in group B was significantly higher in group A(P<0.05), but the sugar content in group B was significantly lower than in group A(P<0.05). However, no significant differences were found in fever,vomiting and meningeal irritation positive abnormal EEG differences between the two groups(P>0.05). Logistic regression analysis showed that higher CSF protein content, lower the sugar content, more obvious disturbance of consciousness, cerebral infarction, time of onset to start of treatment longer than three days were the risk factors for poor prognosis of purulent meningitis(P<0.05).Conclusion: Poor prognosis of purulent meningitis is related to diverse factors. High CSF protein content, low CSF sugar content, obvious disturbance of consciousness, cerebral infarction complication and delay treatment increase the risk of poor bacterial encephalitis prognosis. So further intervention should be taken promptly to prevent the occurrence of complications for those children, and thereby improve their quality of life.