Outcomes and Health Care Resource Utilization of Adult Bacterial Meningitis in the United States.
Neurol Clin Pract
; 11(2): 117-126, 2021 Apr.
Article
en En
| MEDLINE
| ID: mdl-33842064
ABSTRACT
OBJECTIVE:
To examine the longitudinal health care resource utilization, in-hospital mortality, and incidence of downstream complications of bacterial meningitis in the United States.METHODS:
Using IBM MarketScan, we retrieved data on adult patients with a diagnosis of bacterial meningitis admitted to a US hospital between 2008 and 2015. Patients were stratified into groups (1) with/without prior head trauma/neurosurgical complications, (2) nosocomial/community acquisition, and (3) Gram-negative/positive bacteria. Cost data were collected for up to 2 years and analyzed with descriptive statistics and longitudinal modeling.RESULTS:
Among 4,496 patients with bacterial meningitis, 16.5% and 4.6% had preceding neurosurgical complications and head injuries, respectively. Lumbar punctures were performed in 37.3% of patients without prior trauma/complications who went on to develop nosocomial meningitis, and those with prior head injuries or complications had longer initial hospital stays (17.0 days vs 8.0 days). Within a month of diagnosis, 29.2% of patients with bacterial meningitis had experienced downstream complications, most commonly hydrocephalus (12.7%). The worst 30-day mortality was due to tuberculous (12.3%) and streptococcal meningitis (7.2%). Overall, prior head trauma and complications were associated with higher costs. Community-acquired bacterial meningitis had lower median baseline costs relative to the nosocomial group (no head trauma/complication $17,152 vs $82,778; head trauma/complication $92,428 vs $168,309) but higher median costs within 3 months of diagnosis (no head trauma/complication $47,911 vs $34,202; head trauma/complication $89,207 vs $58,947). All costs demonstrated a sharp decline thereafter.CONCLUSIONS:
Bacterial meningitis remains costly and devastating, especially for those who experience traumatic head injuries or have a complicated progress after neurosurgery.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
2_ODS3
/
3_ND
/
4_TD
Problema de salud:
2_enfermedades_transmissibles
/
3_neglected_diseases
/
3_zoonosis
/
4_meningitis
Aspecto:
Implementation_research
Idioma:
En
Revista:
Neurol Clin Pract
Año:
2021
Tipo del documento:
Article
País de afiliación:
Nueva Caledonia