Clinical features, etiologies, and outcomes of central nervous system infections in intensive care: A multicentric retrospective study in a large Brazilian metropolitan area
Authors' conclusion
Patients' overall health, prompt treatment, infection severity, and prolonged respiratory support in the ICU all significantly affect in-hospital mortality rates.
Study context
- Population
- Adults with severe CNS infections admitted to the intensive care unit (ICU), Rio de Janeiro, Brazil, 2012–2019
- Participants
- 451 adults
- Exposure
- Brain abscess vs Encephalitis vs Meningitis
- Brain abscessn = 29
- Encephalitisn = 161
- Meningitisn = 261
- Outcome
- In-hospital mortality and its associated factors
Methodological detailsmulticentre, Patients selected using a prediction tool for suspected central nervous system infections (CNSI); medical records reviewed
- Multicentre
- Patients selected using a prediction tool for suspected CNSI; medical records reviewed
Main finding
As reported in the abstract
In-hospital mortality
Died after a median 11-day hospitalization (5-25 IQR)
69
15.3%
Observational data: associations, not effects.
Further findings
Independent mortality predictors, encephalitis (subgroup)
| OR | P value | |
|---|---|---|
| AIDSMultivariate analysis | 4.3 | P = 0.01 |
| ECOG functional capacity limitationMultivariate analysis | 4.0 | P < 0.01 |
| ICU admission from wardMultivariate analysis | 4.0 | P < 0.01 |
| Mechanical ventilation ≥10 daysMultivariate analysis | 6.1 | P = 0.04 |
| SAPS 3 ≥ 55 pointsMultivariate analysis | 3.2 | P = 0.02 |
Independent mortality predictors, meningitis (subgroup)
| OR | P value | |
|---|---|---|
| Age > 60 yearsMultivariate analysis | 234.2 | P = 0.04 |
| Delay >3 days for treatmentMultivariate analysis | 2.9 | P = 0.04 |
| Mechanical ventilation ≥10 daysMultivariate analysis | 254.3 | P = 0.04 |
| SOFA >3 pointsMultivariate analysis | 2.7 | P = 0.03 |
Mortality predictors, brain abscess (subgroup)
- No associated factors found in multivariate regression
Original publication
Clinical features, etiologies, and outcomes of central nervous system infections in intensive care: A multicentric retrospective study in a large Brazilian metropolitan area. J Crit Care. Published 21 October 2023. doi:10.
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