Jacob Bodilsen1, Michael Dalager-Pedersen2, Henrik Carl Schønheyder3, Henrik Nielsen2. 1. Department of Infectious Diseases, Aalborg University Hospital, Mølleparkvej 4, PO Box 365, 9100 Aalborg, Denmark. Electronic address: jacob.bodilsen@rn.dk. 2. Department of Infectious Diseases, Aalborg University Hospital, Mølleparkvej 4, PO Box 365, 9100 Aalborg, Denmark. 3. Department of Clinical Microbiology, Aalborg University Hospital, Aalborg, Denmark.
Abstract
OBJECTIVES: Stroke is a serious complication in community-acquired bacterial meningitis (CABM), but the incidence, predispositions, and outcome need further clarification; this pertains in particular to the impact of pre-existing atherosclerosis risk factors. Therefore, we aimed to assess these features in a retrospective population-based cohort study. METHODS: We included all patients over 16 years of age with CABM in North Denmark Region, 1998-2010. All data were retrieved from the patient records. A Glasgow Outcome Scale score of 1-4 was defined as an unfavourable outcome and 5 as favourable. RESULTS: We identified 152 episodes of CABM. In 22 (14%) of the episodes, the patient had a stroke; 15 strokes were ischaemic, three were haemorrhagic, and four were a combination of both. Age and atherosclerosis risk factors were not significantly associated with stroke. However, stroke was associated with a higher in-hospital mortality (27% vs. 16%; age adjusted risk ratio (age aj. RR) 1.43, 95% confidence interval (CI) 0.67-3.04), unfavourable outcome (86% vs. 37%; age adj. RR 2.09, 95% CI 1.59-2.75), and long-term sequelae among survivors (88% vs. 40%, age adj. RR 2.01, 95% CI 1.53-2.65) compared with patients without stroke. CONCLUSIONS: Stroke is a common complication among adult CABM patients and is associated with long-term sequelae and possibly also death. However, stroke seemed not to be related to atherosclerosis risk factors.
OBJECTIVES:Stroke is a serious complication in community-acquired bacterial meningitis (CABM), but the incidence, predispositions, and outcome need further clarification; this pertains in particular to the impact of pre-existing atherosclerosis risk factors. Therefore, we aimed to assess these features in a retrospective population-based cohort study. METHODS: We included all patients over 16 years of age with CABM in North Denmark Region, 1998-2010. All data were retrieved from the patient records. A Glasgow Outcome Scale score of 1-4 was defined as an unfavourable outcome and 5 as favourable. RESULTS: We identified 152 episodes of CABM. In 22 (14%) of the episodes, the patient had a stroke; 15 strokes were ischaemic, three were haemorrhagic, and four were a combination of both. Age and atherosclerosis risk factors were not significantly associated with stroke. However, stroke was associated with a higher in-hospital mortality (27% vs. 16%; age adjusted risk ratio (age aj. RR) 1.43, 95% confidence interval (CI) 0.67-3.04), unfavourable outcome (86% vs. 37%; age adj. RR 2.09, 95% CI 1.59-2.75), and long-term sequelae among survivors (88% vs. 40%, age adj. RR 2.01, 95% CI 1.53-2.65) compared with patients without stroke. CONCLUSIONS:Stroke is a common complication among adult CABM patients and is associated with long-term sequelae and possibly also death. However, stroke seemed not to be related to atherosclerosis risk factors.
Authors: A G T A Kariyawasam; C L Fonseka; S D A L Singhapura; J S Hewavithana; H M M Herath; K D Pathirana Journal: Case Rep Neurol Med Date: 2018-09-16