Open AccessAcute Bacterial Meningitis as a Complication of Otitis Media and Related Mortality Factors
Author(s) -
Mehmet Faruk Geyik,
Ömer Faruk Kökoğlu,
Salih Hoşoğlu,
Celal Ayaz
Publication year - 2002
Publication title -
yonsei medical journal/yonsei medical journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.702
H-Index - 63
eISSN - 1976-2437
pISSN - 0513-5796
DOI - 10.3349/ymj.2002.43.5.573
Subject(s) - medicine , meningitis , logistic regression , univariate analysis , acute otitis media , complication , mastoiditis , erythrocyte sedimentation rate , mortality rate , bacterial meningitis , pediatrics , otitis , multivariate analysis , surgery
The aim of this study was to evaluate the characteristics of patients with acute bacterial meningitis (ABM) developed secondary to acute and chronic otitis media (OM). Between 1991 and 2001, among 269 adult patients with ABM, 56 who were secondary to OM were included in the study. We reviewed the charts of patients who were diagnosed as ABM following acute or chronic OM. Risk factors associated with mortality were determined by using a logistic regression model. The mean age of the patients, 38 male and 18 female, was 25.8 +/- 10.8 years (range 14 - 65). Forty-four of these cases (79%) have had chronic OM, of whom 19 (43% of the 44) have also had chronic mastoiditis and 12 (27% of the 44) acute OM. Twenty-three patients (41%) died, during either hospitalization or the follow-up period. Univariate analysis revealed comatose mental status on admission, inappropriate antibiotic treatment before admission, and elevated erythrocyte sedimentation rate (ESR) as significant risk factors for mortality. In multifactorial analysis, comatose mental status (OR=42.5, CI=6.4-280.1, p=0.001) and elevated ESR (OR=1.0, CI=1.01-1.07; p=0.005) remained as significant predictors for mortality. In conclusion, the primary sources of infection leading to the development of ABM should be investigated carefully to reduce the morbidity and mortality rates. It is hoped that this study will raise awareness among general practitioners and otolaryngologists concerning the role of ABM as one of the most important complications of OM.