The Use of Dexamethasone in Bacterial Meningitis in Children and Adults: A Retrospective Analysis

Table 2

Prognostic factors for neurological or audiological sequelae at discharge.

	Neuro/audio sequel (𝑛=21)	No sequel (𝑛=66)	Odds ratio (95% CI)
Age (yr)—mean ± SD	19 ± 26	15 ± 20	—
Males—%	57	47	—
Duration symptoms before admission (hr)—mean ± SD	44 ± 51	33 ± 39	—
Duration symptoms before admission < 24 hrs—no./tot. no. (%)	14/21 (67)	49/64 (76)	0.61 (0.21–1.80)
Received Dexamethasone—no./tot. no. (%)	16/21 (76)	46/66 (70)	1.39 (0.45–4.32)
Received AB in last 48 hr—no./tot. no. (%)	5/21 (24)	7/65 (11)	2.59 (0.72–9.26)
Coexisting conditions—no/tot no (%)
Otitis/sinusitis	6/21 (28)	11/66 (17)	2.00 (0.66–6.30)
Pneumoniae	3/21 (14)	3/66 (4)	3.5 (0.65–18.85)
Immunocompromise	0/21	5/66 (8)	—
Convulsions on admission—no./tot. no. (%)	7/21 (33)	5/66 (8)	6.10 (1.69–22.08)
Findings on admission—no./tot. no. (%)
Normal consciousness	7/21 (33)	45/64 (70)	0.21 (0.074–0.60)
GCS score < 8	0/11	3/50 (6)	—
Focal neurological signs	3/21 (14)	1/66 (2)	10.83 (1.06–110.53)
Temperature > 38°C	17/21 (81)	44/65 (68)	2.03 (0.61–6.78)
Triad (neck stiffness, fever, and altered mental status)	7/13 (54)	9/52 (17)	5.57 (1.51–20.57)
Petechiae	4/21 (19)	36/66 (54)	0.20 (0.060–0.64)
CSF culture—no./tot. no. (%)
S. pneumoniae	14 (67)	11 (17)	10 (3.28–30.48)
N. meningitidis	3 (14)	33 (50)	0.17 (0.045–0.62)
Other bacteria	2 (10)	7 (11)	0.84 (0.17–4.64)
Negative culture	2 (10)	15 (23)	0.36 (0.075–1.72)
CSF parameters
Positive bacterial culture—no./tot. no. (%)	18/21 (86)	50/66 (76)	1.92 (0.50–7.37)
WBC (/mm^3)—mean ± SD	2805 ± 4891	5763 ± 7845	—
WBC < 1000/mm^3—no./tot. no. (%)	11/18 (61)	21/64 (33)	3.22 (1.09–9.49)
Proteins (mg/dL)—mean ± SD	325 ± 248	262 ± 238	—
Proteins > 500 mg/dL—no./tot. no. (%)	5/18 (28)	12/61 (20)	1.57 (0.47–5.26)
Glucose (mg/dL)—mean ± SD	22,2 ± 18,3	42,0 ± 26,3	—
Glucose < 20 mg/dL—no./tot. no. (%)	11/18 (61)	20/62 (32)	3.30 (1.11–9.78)
Glucose CSF/serum ratio (%)—mean ± SD	21 ± 17	33 ± 22	—
Lactate (mmol/L)—mean ± SD	9,9 ± 4,4	7,9 ± 6,3	—
Lactate > 10 mmol/L—no./tot. no. (%)	10/16 (62)	12/48 (25)	5 (1.50–16.68)
Positive blood culture—no./tot. no. (%)	9/20 (45)	33/63 (52)	0.74 (0.27–2.04)
Blood parameters
Hb (g/dL)—mean ± SD	11 ± 2	12 ± 2	—
Platelets (×10^3/mm^3)—mean ± SD	291 ± 141	270 ± 136	—
CRP (mg/L)—mean ± SD	218 ± 134	172 ± 128	—
CRP > 200 mg/L—no./tot. no. (%)	11/21 (52)	23/66 (35)	2.06 (0.76–5.56)
Hyponatremia in first 72u—no./tot. no. (%)	3/21 (14)	3/66 (4)	3.5 (0.65–18.85)
Referred from another hospital—no./tot. no. (%)	7/21 (33)	27/66 (41)	0.72 (0.26–2.03)