Neurocritical Care for the Advanced Practice Clinician by Jessica L. White & Kevin N. Sheth

Author:Jessica L. White & Kevin N. Sheth
Language: eng
Format: epub
Publisher: Springer International Publishing, Cham

13.4.1.8 Prognosis

Indicators of poor outcome include the presence of symptoms for less than 24 h before admission, seizures, pneumonia, an immunocompromised state, a heart rate below 60 bpm or greater than 120 bpm, and hypotension (defined as a diastolic blood pressure of less than 60 mm Hg). The causative organism has been shown to have an independent effect on outcome with an unfavorable outcome being six times that among patients infected with S. pneumoniae compared with patients infected with N. meningitidis, even after adjustment for other clinical predictors [27]. The average mortality rate in this study was 21% and varied depending on the causative organism; it was 30% for pneumococcal meningitis, compared with 7% for meningococcal meningitis and 20% for meningitis due to other pathogens. The most common neurologic deficits identified were hearing loss and hemiparesis [27]. However cognitive dysfunction, behavioral changes, seizures, and motor impairment are additional common complications of meningitis.

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