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Healthcare‐Associated Meningitis or Ventriculitis in Older Adults
Author(s) -
Srihawan Chanunya,
Habib Onaizah,
Salazar Lucrecia,
Hasbun Rodrigo
Publication year - 2017
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/jgs.15099
Subject(s) - medicine , odds ratio , ventriculitis , meningitis , young adult , pediatrics , confidence interval , glasgow coma scale , retrospective cohort study , adverse effect , mechanical ventilation , surgery
Background/Objectives Healthcare‐associated meningitis or ventriculitis ( HCAMV ) is a serious and life‐threatening complication of invasive neurosurgical procedures or penetrating head trauma. Older adults are at higher risk of adverse outcomes in community‐acquired meningitis but studies of HCAMV are lacking. Therefore, we perform the study to define the differences in clinical outcomes between older and younger adults with HCAMV. Design Retrospective study. Setting A large tertiary care hospital in Houston, Texas, from July 2003 to November 2014. Participants Adults with a diagnosis of HCAMV (N = 160) aged ≥65 (n = 35), aged 18–64 (n = 125). Measurements Demographic characteristics, clinical presentation, laboratory results, treatments, and outcomes (Glasgow Outcome Scale). Results Older adults had more comorbidities and CSF abnormalities [pleocytosis, high cerebrospinal fluid ( CSF ) protein, low CSF glucose) and were more likely to have altered mental status than younger adults ( P < .05). An adverse clinical outcome was seen in 142 participants (89%) (death (n = 18, 11%), persistent vegetative state (n = 26, 16%), severe disability (n = 68, 43%), moderate disability (n = 30, 19%). There was no difference in adverse outcomes between older (97%) and younger (86%) adults ( P = .13). On logistic regression analysis, abnormal neurological examination (adjusted odds ratio ( aOR ) = 7.13, 95% confidence interval ( CI ) = 2.15–23.63, P = .001) and mechanical ventilation ( aOR = 11.03, 95% CI = 1.35–90.51, P = .02) were associated with adverse clinical outcomes. Conclusion Older adults with HCAMV have more comorbidities and CSF abnormalities and are more likely to have altered mental status than younger adults but have similar high rates of adverse clinical outcomes.

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