Prognostic indicators of the outcome of meningococcal disease: A study of 562 patients

To assess prognostic indicators of a fatal outcome in patients with meningococcal disease, data from 562 patients with culture-proven meningococcal disease, reported in the Netherlands between 1 April 1989 and 30 April 1990, were collected prospectively by means of a questionnaire completed by the specialist in attendance. Analysis was done by the chi(2) test and multiple logistic regression. During the study period 43 patients (7.7%) died. The risk of a fatal outcome was increased in patients aged 0-5 months, 10-19 years, and greater than or equal to 50 years, in female patients and in patients presenting with coma, temperature less than or equal to 38.0 degrees C, mean arterial pressure less than or equal to 70 mmHg, white blood cell count less than or equal to 10 x 10(9)/L and platelet count less than or equal to 100 x 10(9)/L. Predisposing factors and duration of disease before admission were significantly associated with outcome, but these associations disappeared in the multivariate analysis. Race, the administration of antibiotics prior to admission, seizures and haemorrhagic skin lesions were not associated with outcome. In conclusion age, gender, coma, temperature, mean arterial pressure, white blood cell count and platelet count were independent prognostic indicators of the outcome of meningococcal disease. The assessment of these characteristics may be helpful for the identification of high risk patients, whose prognosis might be improved by prompt transfer to an intensive care unit.