Factors associated with treatment delay and outcome in community acquired bacterial meningitis
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Factors associated with treatment delay and outcome in community acquired bacterial meningitis. / Hovmand, Nichlas; Lundbo, Lene Fogt; Kronborg, Gitte; Darsø, Perle; Benfield, Thomas.
I: IJID Regions, Bind 7, 2023, s. 176-181.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Factors associated with treatment delay and outcome in community acquired bacterial meningitis
AU - Hovmand, Nichlas
AU - Lundbo, Lene Fogt
AU - Kronborg, Gitte
AU - Darsø, Perle
AU - Benfield, Thomas
N1 - Publisher Copyright: © 2023 The Authors
PY - 2023
Y1 - 2023
N2 - Background: Community acquired bacterial meningitis (CABM) is a condition associated with significant morbidity and mortality. Treatment delay remains an area of concern and might be improved by awareness of meningitis among health care professionals. Methods: Retrospective observational study of patients with CABM between 2016 and 2021 in Eastern Denmark with a population of 2,700,000. Data was extracted from electronic health records. Treatment delay and mortality was analyzed using multivariate logistic regression and expressed as odds ratio (OR) with 95% confidence intervals (CI). Results: Of 369 patients 226 (61%) had treatment delayed more than 2 hours. Old age (OR 2.42, CI 1.22;4.77), comorbidity (OR 1.30, CI 1.00;1.70), suspicion of other infections than meningitis (OR 65.93, CI 20.68;210.20), stroke (OR 7.24, CI 3.11;16.86) and other diagnoses (OR 13.00, CI 5.07;33.31) were associated with delayed treatment. Treatment delay was associated with increased 30-day mortality (OR 3.07, 95% CI 1.09;8.67). Most of the treatment delay (82%) was due lack of suspicion of CABM. Conclusions: Treatment delay is a common problem associated with 30-day mortality in CABM. Awareness of CABM in undiagnosed patients is vital to achieve timely initiation of appropriate treatment. Special care should be shown for patients suspected of stroke or other infections.
AB - Background: Community acquired bacterial meningitis (CABM) is a condition associated with significant morbidity and mortality. Treatment delay remains an area of concern and might be improved by awareness of meningitis among health care professionals. Methods: Retrospective observational study of patients with CABM between 2016 and 2021 in Eastern Denmark with a population of 2,700,000. Data was extracted from electronic health records. Treatment delay and mortality was analyzed using multivariate logistic regression and expressed as odds ratio (OR) with 95% confidence intervals (CI). Results: Of 369 patients 226 (61%) had treatment delayed more than 2 hours. Old age (OR 2.42, CI 1.22;4.77), comorbidity (OR 1.30, CI 1.00;1.70), suspicion of other infections than meningitis (OR 65.93, CI 20.68;210.20), stroke (OR 7.24, CI 3.11;16.86) and other diagnoses (OR 13.00, CI 5.07;33.31) were associated with delayed treatment. Treatment delay was associated with increased 30-day mortality (OR 3.07, 95% CI 1.09;8.67). Most of the treatment delay (82%) was due lack of suspicion of CABM. Conclusions: Treatment delay is a common problem associated with 30-day mortality in CABM. Awareness of CABM in undiagnosed patients is vital to achieve timely initiation of appropriate treatment. Special care should be shown for patients suspected of stroke or other infections.
KW - Fever
KW - Hospital care
KW - Infection
KW - Meningitis
KW - Treatment delay
UR - http://www.scopus.com/inward/record.url?scp=85152301321&partnerID=8YFLogxK
U2 - 10.1016/j.ijregi.2023.03.013
DO - 10.1016/j.ijregi.2023.03.013
M3 - Journal article
C2 - 37123382
AN - SCOPUS:85152301321
VL - 7
SP - 176
EP - 181
JO - IJID Regions (Online)
JF - IJID Regions (Online)
SN - 2772-7076
ER -
ID: 367340177