Adverse outcomes of bacterial meningitis in school aged survivors

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dc.contributor.authorGrimwood, K.
dc.contributor.authorAnderson, V.
dc.contributor.authorBond, L.
dc.contributor.authorCatroppa, C.
dc.contributor.authorHore, R.
dc.contributor.authorKeir, E.
dc.contributor.authorNolan, T.
dc.contributor.authorRoberton, D.
dc.date.issued1995
dc.description.abstract<h4>Objective</h4>To determine the outcomes of bacterial meningitis in school-age survivors.<h4>Design</h4>Prospective cohort study.<h4>Setting</h4>Teaching pediatric hospital.<h4>Children</h4>During 1983 through 1986, 158 meningitis survivors, ages 3 months to 14 years, treated at a single center were enrolled. Between 1991 and 1993, 130 children, 82% of the original cohort, were evaluated at a mean age of 8.4 years and a mean of 6.7 years after their meningitis.<h4>Outcome measures</h4>Blinded neurologic, neuropsychologic, audiologic, behavior, and socio-demographic assessments were compared with those from grade- and sex-matched control children. Multivariate analyses adjusted for age at testing and socio-demographic variables.<h4>Results</h4>There was a systematic increase in risk of abnormality or poorer functioning for children with meningitis, compared with control children, across all categories tested, which was significant for fine motor function, Intelligence quotient (IQ) scores, and tests of school behavior, neuropsychologic function, and auditory figure-ground differentiation. Eleven children who had experienced meningitis (8.5%) had major deficits (IQ < 70, seizures, hydrocephalus, spasticity, blindness, or severe to profound hearing loss); a further 24 (18.5%) cases and 14 (10.8%) control children had minor deficits (IQ 70 to 80, inability to read, mild to moderate hearing loss, abnormalities in speech discrimination, or school behavior problems). Overall, children who had meningitis were at greater risk (26.9%) for disability. Children with acute neurologic complications had more adverse outcomes than those with uncomplicated meningitis and control children (39% vs 18% vs 11%, respectively).<h4>Conclusions</h4>One in four school-age meningitis survivors has either serious and disabling sequelae or a functionally important behavior disorder, neuropsychologic or auditory dysfunction adversely affecting academic performance. As a group, survivors function less well than their classroom peers, and risk is greatest for, but not confined to, those who had acute neurologic complications. All survivors require careful follow-up, at least until school age.
dc.identifier.citationPediatric Research, 1995; 95(5):646-656
dc.identifier.issn0031-3998
dc.identifier.issn1098-4275
dc.identifier.urihttp://hdl.handle.net/2440/7803
dc.language.isoen
dc.publisherS. Karger
dc.rights1995 © Copyright American Academy of Pediatrics.
dc.source.urihttp://pediatrics.aappublications.org/cgi/content/abstract/95/5/646
dc.subjectHumans
dc.subjectMeningitis, Bacterial
dc.subjectHearing Disorders
dc.subjectNervous System Diseases
dc.subjectRisk Factors
dc.subjectCase-Control Studies
dc.subjectFollow-Up Studies
dc.subjectIntelligence
dc.subjectChild Behavior Disorders
dc.subjectDevelopmental Disabilities
dc.subjectNeuropsychological Tests
dc.subjectAdolescent
dc.subjectChild
dc.subjectChild, Preschool
dc.subjectInfant
dc.subjectSurvivors
dc.subjectFemale
dc.subjectMale
dc.titleAdverse outcomes of bacterial meningitis in school aged survivors
dc.typeJournal article
pubs.publication-statusPublished

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