Brain ventricular dimensions and relationship to outcome in adult patients with bacterial meningitis

TY - JOUR

T1 - Brain ventricular dimensions and relationship to outcome in adult patients with bacterial meningitis

AU - Sporrborn, Janni L

AU - Knudsen, Gertrud B

AU - Sølling, Mette

AU - Seierøe, Karina

AU - Farre, Annette

AU - Lindhardt, Bjarne Ø

AU - Benfield, Thomas

AU - Brandt, Christian T

PY - 2015/8/25

Y1 - 2015/8/25

N2 - BACKGROUND: Experimental studies suggest that changes in brain ventricle size are key events in bacterial meningitis. This study investigated the relationship between ventricle size, clinical condition and risk of poor outcome in patients with bacterial meningitis.METHODS: Adult patients diagnosed with bacterial meningitis admitted to two departments of infectious diseases from 2003 through 2010 were identified. Clinical and biochemical data as well as cerebral computed tomographic images were collected. The size of the brain ventricles were presented as a Ventricle to Brain Ratio (VBR). Normal range of VBR was defined from an age matched control group. A multivariate analysis was performed to identify predictors of 30-day mortality.RESULTS: One hundred and seven patients were included. Eighty-one patients had a CT scan at the time of diagnosis. VBR was identified as an independent risk factor of 30-day mortality, Mortality Rate Ratio: 6.03 (95 % confidence interval: 1.61-22.64, p = 0.008) for highest versus lowest tertile. A VBR deviating more than 2 standard deviations from the normal range was associated with increased mortality.CONCLUSIONS: Brain ventricles are commonly subject to marked changes in size as a consequence of meningitis. Increased brain ventricle size in the acute phase of bacterial meningitis was associated with increased mortality.

AB - BACKGROUND: Experimental studies suggest that changes in brain ventricle size are key events in bacterial meningitis. This study investigated the relationship between ventricle size, clinical condition and risk of poor outcome in patients with bacterial meningitis.METHODS: Adult patients diagnosed with bacterial meningitis admitted to two departments of infectious diseases from 2003 through 2010 were identified. Clinical and biochemical data as well as cerebral computed tomographic images were collected. The size of the brain ventricles were presented as a Ventricle to Brain Ratio (VBR). Normal range of VBR was defined from an age matched control group. A multivariate analysis was performed to identify predictors of 30-day mortality.RESULTS: One hundred and seven patients were included. Eighty-one patients had a CT scan at the time of diagnosis. VBR was identified as an independent risk factor of 30-day mortality, Mortality Rate Ratio: 6.03 (95 % confidence interval: 1.61-22.64, p = 0.008) for highest versus lowest tertile. A VBR deviating more than 2 standard deviations from the normal range was associated with increased mortality.CONCLUSIONS: Brain ventricles are commonly subject to marked changes in size as a consequence of meningitis. Increased brain ventricle size in the acute phase of bacterial meningitis was associated with increased mortality.

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Brain

KW - Cerebral Ventricles

KW - Denmark

KW - Female

KW - Humans

KW - Male

KW - Meningitis, Bacterial

KW - Middle Aged

KW - Multivariate Analysis

KW - Retrospective Studies

KW - Risk Factors

KW - Survival Analysis

KW - Tomography, X-Ray Computed

U2 - 10.1186/s12879-015-1097-3

DO - 10.1186/s12879-015-1097-3

M3 - Journal article

C2 - 26303023

SN - 1471-2334

VL - 15

SP - 1

EP - 9

JO - B M C Infectious Diseases

JF - B M C Infectious Diseases

M1 - 367

ER -