Predictive value of the APACHE II, SAPS II, SOFA and GCS scoring systems in patients with severe purulent bacterial meningitis.

BACKGROUND Scoring systems in critical care patients are essential for predicting of the patient outcome and evaluating the therapy. In this study, we determined the value of the Acute Physiology and Chronic Health Evaluation II (APACHE II), Simplified Acute Physiology Score II (SAPS II), Sequential Organ Failure Assessment (SOFA) and Glasgow Coma Scale (GCS) scoring systems in the prediction of mortality in adult patients admitted to the intensive care unit (ICU) with severe purulent bacterial meningitis. METHODS We retrospectively analysed data from 98 adult patients with severe purulent bacterial meningitis who were admitted to the single ICU between March 2006 and September 2015. RESULTS Univariate logistic regression identified the following risk factors of death in patients with severe purulent bacterial meningitis: APACHE II, SAPS II, SOFA, and GCS scores, and the lengths of ICU stay and hospital stay. The independent risk factors of patient death in multivariate analysis were the SAPS II score, the length of ICU stay and the length of hospital stay. In the prediction of mortality according to the area under the curve, the SAPS II score had the highest accuracy followed by the APACHE II, GCS and SOFA scores. CONCLUSIONS For the prediction of mortality in a patient with severe purulent bacterial meningitis, SAPS II had the highest accuracy.

[1]  D. Villers,et al.  Rifampin use in acute community-acquired meningitis in intensive care units: the French retrospective cohort ACAM-ICU study , 2015, Critical Care.

[2]  H. Hasan,et al.  BURDEN OF BACTERIAL MENINGITIS: A RETROSPECTIVE REVIEW ON LABORATORY PARAMETERS AND FACTORS ASSOCIATED WITH DEATH IN MENINGITIS, KELANTAN MALAYSIA , 2015, Nagoya journal of medical science.

[3]  Juhász Mónika,et al.  Patients with type-1 and type-2 diabetes mellitus in the program of peritoneal dialysis , 2015 .

[4]  A. Piotrowska,et al.  Meningitis and encephalitis in Poland in 2013. , 2015, Przeglad Epidemiologiczny.

[5]  J. Gonçalves-Pereira,et al.  Acute bacterial meningitis in the intensive care unit and risk factors for adverse clinical outcomes: retrospective study. , 2014, Journal of critical care.

[6]  L. Kępa,et al.  Cerebrospinal fluid interleukin-6 concentration in patients with purulent, bacterial meningitis - own observations. , 2014, Przeglad epidemiologiczny.

[7]  S. Modi,et al.  Phenotypic Characterization and Antibiogram of CSF Isolates in Acute Bacterial Meningitis. , 2013, Journal of clinical and diagnostic research : JCDR.

[8]  N. French,et al.  High Mortality amongst Adolescents and Adults with Bacterial Meningitis in Sub-Saharan Africa: An Analysis of 715 Cases from Malawi , 2013, PloS one.

[9]  A. van der Ende,et al.  Listeria monocytogenes sequence type 6 and increased rate of unfavorable outcome in meningitis: epidemiologic cohort study. , 2013, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[10]  S. Hugonnet,et al.  Timely detection of bacterial meningitis epidemics at district level: a study in three countries of the African Meningitis Belt. , 2013, Transactions of the Royal Society of Tropical Medicine and Hygiene.

[11]  G. Thwaites,et al.  Advances in treatment of bacterial meningitis , 2012, The Lancet.

[12]  P. Berche,et al.  Diagnosis of Listeria monocytogenes Meningoencephalitis by Real-Time PCR for the hly Gene , 2011, Journal of Clinical Microbiology.

[13]  Diederik van de Beek,et al.  Epidemiology, Diagnosis, and Antimicrobial Treatment of Acute Bacterial Meningitis , 2010, Clinical Microbiology Reviews.

[14]  Pan‐Chyr Yang,et al.  Management of severe community-acquired septic meningitis in adults: from emergency department to intensive care unit. , 2009, Journal of the Formosan Medical Association = Taiwan yi zhi.

[15]  A. van der Ende,et al.  Clinical Features, Outcome, and Meningococcal Genotype in 258 Adults With Meningococcal Meningitis: A Prospective Cohort Study , 2008, Medicine.

[16]  G. Thwaites,et al.  The diagnosis and management of acute bacterial meningitis in resource-poor settings , 2008, The Lancet Neurology.

[17]  M. Falagas,et al.  Vaccination of asplenic or hyposplenic adults , 2008, The British journal of surgery.

[18]  C. Whitty,et al.  Corticosteroids for bacterial meningitis in adults in sub-Saharan Africa. , 2007, The New England journal of medicine.

[19]  O. Sipahi,et al.  Pooled Analysis of 2,408 Cases of Acute Adult Purulent Meningitis from Turkey , 2007, Medical Principles and Practice.

[20]  M. Brouwer,et al.  Community-acquired recurrent bacterial meningitis in adults. , 2007, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[21]  B. Schmand,et al.  Cognitive outcome in adults after bacterial meningitis , 2007, Journal of Neurology, Neurosurgery, and Psychiatry.

[22]  B. Lorber.  Community-acquired Listeria monocytogenes meningitis in adults. , 2007, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[23]  F. Lellouche,et al.  Adults with spontaneous aerobic Gram-negative bacillary meningitis admitted to the intensive care unit. , 2006, Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases.

[24]  J. Reitsma,et al.  Clinical features, complications, and outcome in adults with pneumococcal meningitis: a prospective case series , 2006, The Lancet Neurology.

[25]  N. Weightman,et al.  Incidence and outcome of pneumococcal meningitis in northern England , 2005, European Journal of Clinical Microbiology and Infectious Diseases.

[26]  F. Schellevis,et al.  Increased risk of common infections in patients with type 1 and type 2 diabetes mellitus. , 2005, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[27]  F. Murillo-Cabezas,et al.  Acute community-acquired bacterial meningitis in adults admitted to the intensive care unit: clinical manifestations, management and prognostic factors , 2003, Intensive Care Medicine.

[28]  H. Pfister,et al.  Pneumococcal meningitis in adults: spectrum of complications and prognostic factors in a series of 87 cases. , 2003, Brain : a journal of neurology.

[29]  R. Porcher,et al.  Pneumococcal meningitis in the intensive care unit: prognostic factors of clinical outcome in a series of 80 cases. , 2002, American journal of respiratory and critical care medicine.

[30]  J. Kolls,et al.  Alcohol, host defence and society , 2002, Nature Reviews Immunology.

[31]  F. Asensi Botet,et al.  [Pneumococcal meningitis]. , 2001, Anales espanoles de pediatria.

[32]  S. Shafran,et al.  Acute Bacterial Meningitis in Adults: A 12‐Year Review , 2000, Medicine.

[33]  M. Mufson,et al.  A 20-year epidemiological study of pneumococcal meningitis. , 1999, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[34]  V. Caviness,et al.  Acute bacterial meningitis in adults. A review of 493 episodes. , 1993, The New England journal of medicine.