Long-term neuro-functional disability in adult patients with community-acquired bacterial meningitis
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Akroum, Souade | Tubiana, Sarah | de Broucker, Thomas | Dournon, Nathalie | Varon, Emmanuelle | Ploy, Marie Cécile | Mourvillier, Bruno | Oziol, Eric | Lacassin, Flore | Laurichesse, Henri | Hoen, Bruno | Duval, Xavier | Burdet, Charles | Duval, X | Hoen, B | Mourvillier, B | Varon, E | Tubiana, S | Ploy, M. | Caron, F | Bollaert, Pe. | Gaillot, O | Taha, Mk. | Poyart, C | Bonacorsi, S | Vandenesch, F | Cambau, E | Lecuit, M | Gravet, A | Frachet, B | de Broucker, T | Levy Bruhl, D | Raffi, F | Abraham, B | Ader, F | Ancel, E | Anguel, N | Argaud, L | Arista, S | Armand-Lefevre, L | Bachelier, M. | Balavoine, S | Baraduc, R | Barnaud, G | Beraud, G | Bertei, D | Bessede, E | Billard Pomares, T | Biron, C | Blanchard-Marche, G | Bland, S | Boileau, J | Bornstain, C | Bourdon, S | Bousquet, A | Boyer, S | Bozorg-Grayeli, A | Bret, L | Bricaire, F | Brocas, E | Brun, M | Buret, J | Burucoa, C | Camuset, G | Canevet, C | Carricajo, A | Casin, I | Cassignard, D | Castan, B | Cazanave, C | Challan-Belval, T | Chandesris, C | Chanteperdrix-Marillier, V | Chaplain, C | Charlier-Woerther, C | Chaussade, H | Chirouze, C | Chomarat, M | Claessens, Y. | Clair, B | Combaux, D | Conil, J. | Cordel, H | Cormier, P | Cousson, J | Cronier, P | Cua, E | Daneluzzi, V | Dao Dubremetz, A | Defarcy, A | Degand, N | Dekeyser, S | Delaune, D | Denes, E | Descamps, D | Desmaretz, J. | Devaud, E | Di Palma, M. | Diamantis, S | Diehl, J. | Dimet, J | Dinh, A | Descloux, E | Colot, J | Emirian, A | Epaulard, O | Escaut, L | Fabe, C | Ferry, T | Fiette, H | Flateau, C | Fonsale, N | Forestier, E | Fortineau, N | Fraisse, T | Faibis, F | Froidure, M | Gabriel-Solean, S | Gagneux-Brunon, A | Garcia, M | Garnier, V | Gaudry, S | Ghozzi, R | Gregoire-Faucher, V | Grosset, M | Gueit, I | Guelon, D | Guillet Caruba, C | Guimard, T | Guimard, Y | Guinard, J | Hadou, T | Helene, J. | Henard, S | Henry, B | Hernu, R | Hochart, A. | Idri, N | Illes, G | Jacob, X | Jaffuel, S | Jan, D | Jarrin, I | Jaureguy, F | Joseph, C | Juvin, M. | Kayal, S | Lacassin, F | Lafaurie, M | Lalanne, B | Lamaury, I | Lanotte, P | Lartigue, M. | Latorre, Y | Laudat, P | Laurens, E | Laurichesse, H | Le Brun, C | Le Moing, V | Le Turnier, P | Lecuyer, H | Ledru, S | Legout, L | Legrix, C | Lemaignen, A | Lemble, C | Lemee, L | Leotard, S | Lesens, O | Lesprit, P | Levast, M | Louis, F | Quaesaet, L | Luizy, N | Males, S | Malpote, E | Martin-Blondel, G | Martinez, V | Masson, R | Matray, O | Mbadi, A | Mechai, F | Merens, A | Meyohas, M. | Michel, G | Michon, A | Mootien Yoganaden, J | Morquin, D | Mouly, S | Mrozek, N | Nguyen, S | Nguyen, Y | Odinotte, A | Ogielska, M | Oziol, E | Page, B | Parisi-Duchene, E | Pasdeloup, T | Patrat-Delon, S | Patry, I | Pechinot, A | Pelloux, I | Picot, S | Pierre, J | Piroth, L | Plassart, C | Plessis, P | Ploton, C | Ploy, M | Portel, L | Poupard, M | Prazuck, T | Ramanantsoa, A | Rapp, C | Raskine, L | Raymond, J | Revest, M | Riche, A | Robaday-Voisin, S | Robin, F | Roblot, F | Romaszko, J. | Rousseau, F | Roux, A | Royer, C | Saada, M | Salmon, D | Saroufim, C | Schmit, J | Sebire, M | Segonds, C | Sifaoui, F | Sivadon-Tardy, V | Soismier, N | Solen, K | Sommabere, A | Son, O | Stahl, Jp | Steux, R | Sunder, S | Suy, F | Tande, D | Tankovic, J | Tigaud, S | Tourrand, B | Valin, N | van Grunderbeeck, N | Vatan, R | Venot, C | Vergnaud, M | Vidal, M | Vitrat, V | Vittecoq, D | Vuotto, F | Chabrol, A | Cabalion, J | Gorenne, Isabelle | Laouenan, Cédric | Marcault, Estelle | Mentre, France | Pasquet, Blandine | Roy, Carine | Laouenan, C | Gorenne, I | Marcault, E | Manchon, P | Pasquet, B | Roy, C
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CCSD ; Springer Verlag -
International audience.
PurposeTo investigate the prevalence of neuro-functional disability and its determinants 12 months after community-acquired bacterial meningitis (CABM) in adult patients.MethodsIn a prospective multicenter cohort study (COMBAT), all consecutive cases of CABM were enrolled and followed up for 12 months. Neuro-functional disability at 12 months was evaluated using a combination of the Glasgow Outcome Scale (functional disability), and the modified Rankin Disability Scale (physical disability). Factors associated with neuro-functional disability were identified by multivariate logistic regression.ResultsAmong 281 patients, 84 (29.9%) patients exhibited neuro-functional disability at 12 months: 79 (28.1%) with functional disability and 51 (18.1%) with physical disability. Overall, 6 patients (2.1%) died during the follow-up. The most common pathogen identified was Streptococcus pneumoniae (131/272, 48.2%); 77/268 patients (28.7%) had a physical disability at hospital discharge. Factors independently associated with 12-month neuro-functional disability were a pneumococcal meningitis (adjusted OR = 2.8; 95% confidence interval (CI) = [1.3; 6.7]), the presence of a physical disability at hospital discharge (aOR = 2.3; 95%CI = [1.2; 4.4]) and the presence of behavioral disorders at hospital-discharge (aOR = 5.9; 95%CI = [1.6; 28.4]). Dexamethasone use was not significantly associated with neuro-functional disability (OR = 0.2; 95%CI = [< 0.1;1.3]).ConclusionNeuro-functional disability is frequently reported 12 months after CABM. Detailed neurological examination at discharge is needed to improve the follow-up.
