Mortality Prediction in Patients with Post-Operative Meningitis: One Longitudinal Study in Iran

Background: Post-operative meningitis(POM) is the important challenge with high mortality in the neurosurgery Objectives: To identify related factors to predict mortality rate of post-operative meningitis. Methods: This descriptive longitudinal study, conducted on patients affected by postoperative meningitis within 30 days after neurosurgery from 2017 to 2018, in one subspecialty hospital, Tehran, Iran. Total basic characteristics of patients diagnosed with POM collected and they followed for 30 days. The mortality rate was estimated. For data analysis Chi2 and Fisher exact, so, independent t and Mann-Whitney U, the test used. As well as multivariable logistic regression analysis showed predictor factors of patient's outcome. Finally, Survival curve was executed by SPSS 19. A significant level was considered P < 0.05 for all tests. Results: In this study, the mortality rate was 5.6 times incidence rate. Inmultivariable logistic regression analysis, having mechanical ventilation (P = 0.03, OR = 1.1, 95% CI=1.05 - 5.1), length of ICU stays more than 7 days (P = 0.04, OR = 1.2, 95% CI = 0.04 - 6.2), positive cerebrospinal fluid leakage (CSF) culture (P = 0.01, OR = 2.4, 95% CI = 1.9 - 4.08) were forecasting factors to poor outcome. Finally, an inverse relationship between survival function and length of ICU stay in patients affected by postoperative meningitis reported. Conclusions: According to the high rate of mortality and predictor factors in POM, further studies are recommended to find preventive strategies to decrease this dreaded cause of morbidity and mortality in neurosurgical patients.