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Risk Factors in Predicting Prognosis of Neonatal Bacterial Meningitis—A Systematic Review

Background: Neonatal bacterial meningitis is a severe infection with high mortality and morbidity. It is necessary to identify factors associated with a high risk of a poor prognosis so that we can prevent them with more appropriate treatments. This study was performed to summarize the prognostic fa...

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Autores principales: Mao, Dan-Hua, Miao, Jing-Kun, Zou, Xian, Chen, Na, Yu, Lin-Chao, Lai, Xin, Qiao, Meng-Yuan, Chen, Qi-Xiong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6255960/
https://www.ncbi.nlm.nih.gov/pubmed/30515129
http://dx.doi.org/10.3389/fneur.2018.00929
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author Mao, Dan-Hua
Miao, Jing-Kun
Zou, Xian
Chen, Na
Yu, Lin-Chao
Lai, Xin
Qiao, Meng-Yuan
Chen, Qi-Xiong
author_facet Mao, Dan-Hua
Miao, Jing-Kun
Zou, Xian
Chen, Na
Yu, Lin-Chao
Lai, Xin
Qiao, Meng-Yuan
Chen, Qi-Xiong
author_sort Mao, Dan-Hua
collection PubMed
description Background: Neonatal bacterial meningitis is a severe infection with high mortality and morbidity. It is necessary to identify factors associated with a high risk of a poor prognosis so that we can prevent them with more appropriate treatments. This study was performed to summarize the prognostic factors known to predict adverse outcomes in neonatal bacterial meningitis. Methods: The Medline/PubMed, Cochrane Library and Embase databases were searched for studies of prognostic risk factors in neonates with bacterial meningitis. Studies published from the initiation of the database to April 30th, 2017 were included. The quality of cohort studies was assessed by the Newcastle-Ottawa Scale (NOS). The quality of cross-section studies was assessed by the Agency for Healthcare Research and Quality (AHRQ) scale. Each prognostic factor known to cause adverse outcomes is summarized. Results: Sixteen studies were identified, including 7 cohort studies and 9 cross section studies. Seizure and high protein levels in the cerebrospinal fluid (CSF) predict a poor prognosis in this disease. Coma, the need for ventilation support, and leukopenia also had some value for predicting poor prognoses. A bulging anterior fontanelle was valuable for predicting mortality. Low CSF glucose levels, thrombocytopenia, gestational age (GA) < 37 weeks and an altered sensorium were correlated with a poor prognosis. A birth weight < 2500 g, early onset meningitis and positive CSF cultures were correlated with mortality. Conclusions: This study provides a preliminary exploration of prognostic factors in neonatal bacterial meningitis and thereby fills some of the gaps in the study of prognoses in this disease. These prognostic factors can be used to predict and estimate outcomes in neonatal bacterial meningitis. Without a meta-analysis, the reliability of these factors cannot be assured. In addition, these results emphasize that there is an urgent need for a standardized protocol for follow-up and well-designed prognostic studies in neonatal bacterial meningitis.
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spelling pubmed-62559602018-12-04 Risk Factors in Predicting Prognosis of Neonatal Bacterial Meningitis—A Systematic Review Mao, Dan-Hua Miao, Jing-Kun Zou, Xian Chen, Na Yu, Lin-Chao Lai, Xin Qiao, Meng-Yuan Chen, Qi-Xiong Front Neurol Neurology Background: Neonatal bacterial meningitis is a severe infection with high mortality and morbidity. It is necessary to identify factors associated with a high risk of a poor prognosis so that we can prevent them with more appropriate treatments. This study was performed to summarize the prognostic factors known to predict adverse outcomes in neonatal bacterial meningitis. Methods: The Medline/PubMed, Cochrane Library and Embase databases were searched for studies of prognostic risk factors in neonates with bacterial meningitis. Studies published from the initiation of the database to April 30th, 2017 were included. The quality of cohort studies was assessed by the Newcastle-Ottawa Scale (NOS). The quality of cross-section studies was assessed by the Agency for Healthcare Research and Quality (AHRQ) scale. Each prognostic factor known to cause adverse outcomes is summarized. Results: Sixteen studies were identified, including 7 cohort studies and 9 cross section studies. Seizure and high protein levels in the cerebrospinal fluid (CSF) predict a poor prognosis in this disease. Coma, the need for ventilation support, and leukopenia also had some value for predicting poor prognoses. A bulging anterior fontanelle was valuable for predicting mortality. Low CSF glucose levels, thrombocytopenia, gestational age (GA) < 37 weeks and an altered sensorium were correlated with a poor prognosis. A birth weight < 2500 g, early onset meningitis and positive CSF cultures were correlated with mortality. Conclusions: This study provides a preliminary exploration of prognostic factors in neonatal bacterial meningitis and thereby fills some of the gaps in the study of prognoses in this disease. These prognostic factors can be used to predict and estimate outcomes in neonatal bacterial meningitis. Without a meta-analysis, the reliability of these factors cannot be assured. In addition, these results emphasize that there is an urgent need for a standardized protocol for follow-up and well-designed prognostic studies in neonatal bacterial meningitis. Frontiers Media S.A. 2018-11-20 /pmc/articles/PMC6255960/ /pubmed/30515129 http://dx.doi.org/10.3389/fneur.2018.00929 Text en Copyright © 2018 Mao, Miao, Zou, Chen, Yu, Lai, Qiao and Chen. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Neurology
Mao, Dan-Hua
Miao, Jing-Kun
Zou, Xian
Chen, Na
Yu, Lin-Chao
Lai, Xin
Qiao, Meng-Yuan
Chen, Qi-Xiong
Risk Factors in Predicting Prognosis of Neonatal Bacterial Meningitis—A Systematic Review
title Risk Factors in Predicting Prognosis of Neonatal Bacterial Meningitis—A Systematic Review
title_full Risk Factors in Predicting Prognosis of Neonatal Bacterial Meningitis—A Systematic Review
title_fullStr Risk Factors in Predicting Prognosis of Neonatal Bacterial Meningitis—A Systematic Review
title_full_unstemmed Risk Factors in Predicting Prognosis of Neonatal Bacterial Meningitis—A Systematic Review
title_short Risk Factors in Predicting Prognosis of Neonatal Bacterial Meningitis—A Systematic Review
title_sort risk factors in predicting prognosis of neonatal bacterial meningitis—a systematic review
topic Neurology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6255960/
https://www.ncbi.nlm.nih.gov/pubmed/30515129
http://dx.doi.org/10.3389/fneur.2018.00929
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