Long-Term Disabilities Following Childhood Bacterial Meningitis

Field: Medicine (Health Sciences)

Research Article| May 01 2024 Long-Term Disabilities Following Childhood Bacterial Meningitis AAP Grand Rounds (2024) 51 (5): 54. https://doi.org/10.1542/gr.51-5-54 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn Email Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Long-Term Disabilities Following Childhood Bacterial Meningitis. AAP Grand Rounds May 2024; 51 (5): 54. https://doi.org/10.1542/gr.51-5-54 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search toolbar search search input Search input auto suggest filter your search All PublicationsAll JournalsAAP Grand RoundsPediatricsHospital PediatricsPediatrics In ReviewNeoReviewsAAP NewsAll AAP Sites Search Advanced Search Topics: bacterial meningitis, disability Source: Mohanty S, Kostenniemi UJ, Silfverdal SA, et al. Increased risk of long-term disabilities following childhood bacterial meningitis in Sweden. JAMA Network Open. 2024;7(1):e2352402. doi: https://doi.org/10.1001/jamanetworkopen.2023.52402.Google Scholar Investigators from multiple institutions conducted a retrospective matched cohort study to assess the long-term risk of disabilities following childhood bacterial meningitis. For the study, they reviewed multiple national registries in Sweden and used the Swedish national registration number assigned to residents at birth to link databases. Study participants were individuals with ICD-9 or ICD-10 diagnostic code for bacterial meningitis before the age of 18 years, occurring between 1987 and 2021. These participants were matched 1:9 with controls without a record of bacterial meningitis. The primary outcomes were diagnosis of 7 disabilities, including cognitive disabilities, seizures, hearing loss, motor function disorders, visual disturbances, behavioral and emotional disorders, and intracranial structural injuries during follow-up. These outcomes were identified using ICD-9 and ICD-10 codes. The cumulative rates of each of these disabilities in the 2 cohorts were estimated using Kaplan-Meier curves. The risk of each disability was compared in individuals with a history of bacterial meningitis (cases) and controls using Cox proportional hazards regression, after adjusting for multiple demographic and birth characteristics. Subgroup analyses for participants with bacterial meningitis caused by S. pneumoniae, H. influenzae, and N. meningitidis also were conducted using Cox regression to compare risks to controls and between different pathogens. A total of 3,623 individuals diagnosed with bacterial meningitis were matched to 32,607 controls. The median follow-up time for participants was 23.7 years. For cases, the median age at diagnosis was 1.5 years, with 24.5% of cases of meningitis caused by H. influenzae, 15.8% by S. pneumoniae, 13.7% by N. meningitidis, and the remainder caused by other or undetermined bacteria. Rates of all 7 disabilities were higher among those with a history of bacterial meningitis than in controls. The cumulative incidence of disabilities in cases ranged from 3.6% for intracranial structural injuries to 13.7% for behavioral and emotional disorders; 8.0% had seizures and 10% hearing loss. After adjusting for covariates, the risk of each disability was significantly higher among those in the meningitis cohort than in controls, including cognitive disabilities (adjusted hazard ratio [aHR], 3.23; 95% CI, 2.71, 3.85), seizures (aHR, 4.14; 95% CI, 3.46, 4.96), and hearing loss (aHR, 7.00; 95% CI, 6.68, 9.33). Among the individual pathogens, and after excluding intracranial structural injuries, cases with S. pneumoniae were at significantly increased risk compared to controls for all disabilities except behavioral and emotional disorders, and those with H. influenzae meningitis were at significantly increased risk for all except behavioral and emotional disorders and visual disturbances. Risks of cognitive disabilities, seizures, hearing loss, and motor function disorders were significantly higher among cases with S. pneumoniae meningitis than in those affected by H. influenzae. The only significant difference in risk between those with H. influenzae and N. meningitidis meningitis was for cognitive disabilities. The... You do not currently have access to this content.