Hemodynamics, fluids & transfusion
Hemodynamic and neurological presentations of invasive meningococcal disease in adults: a nationwide study across 100+ French intensive care unit (ICUs) : The RETRO-MENINGO study
Main finding · Day-60 mortalityResult — go to the resultAdjusted odds ratio 4.33 95% CI 2.26–8.62Authors' conclusion
Neurological and hemodynamic presentation of IMD are clinically and prognostically distinct.
Study context
- Population
- Adults (≥ 18 years) admitted to the ICU with microbiologically confirmed invasive meningococcal disease, 102 French ICUs, 2016–2024
- Participants
- 654 adults · 102 French ICUs
- Exposure
- Hemodynamic vs neurological presentation of invasive meningococcal disease (IMD) at ICU admission
- Hemodynamicn = 247
- Neurologicaln = 407reference
- Outcome
- Mortality in each presentation
- Follow-up
- Day 60
Methodological detailsnationwide, multicentre
- Nationwide
- Multicentre
Main finding
Day-60 mortality
Adjusted odds ratio
4.33
95% CI 2.26–8.62
P < 0.001
By group
Hemodynamic vs Neurological
aOR 4.33 (95% CI 2.26–8.62); P < 0.001
As reported in the abstract
Observational data: associations, not effects.
Further findings
Baseline characteristics
- Age, Hemodynamic vs Neurological (years)
- 39.0 vs. 30.0; p = 0.001
- Immunosuppression
- 17.0% vs. 7.1%; p < 0.001
- Purpuric rash
- 55.9% vs. 43.7%; p = 0.003
- Time to ICU admission (days)
- 1 vs. 2; p = 0.001
- Bacteremia
- 83.8% vs. 35.6%; p < 0.001
- Serogroup B predominant in neurological, W135 more common in hemodynamic presentation
- More organ support (vasopressors, invasive mechanical ventilation, transfusions, RRT) in hemodynamic presentation
Other independent factors for day-60 mortality
- Absence of comorbidities, aOR
- 2.21 (1.19-4.23); p = 0.014 (95% CI)
- Age > 35 years, aOR
- 3.65 (1.73-6.07); p < 0.001 (95% CI)
- Arterial lactate > 5 mmol/L, aOR
- 2.60 (1.43-4.77); p = 0.002 (95% CI)
- Symptom onset < 24 h, aOR
- 1.90 (1.00-3.55); p = 0.040 (95% CI)
- Early parenteral third-generation cephalosporin before ICU admission (protective), aOR
- 0.31 (0.18-0.55); p < 0.001 (95% CI)
Original publication
Hemodynamic and neurological presentations of invasive meningococcal disease in adults: a nationwide study across 100+ French ICUs : The RETRO-MENINGO study. Intensive Care Med. Published 12 August 2025. doi:10.
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