Long-Term Mortality in Patients Diagnosed With Pneumococcal Meningitis: A Danish Nationwide Cohort Study

摘要

The objective of the study was to determine the long-term mortality and the causes of death in patients di-nagnosed with pneumococcal meningitis. The authors performed a nationwide, population-based cohort studynincluding all Danish patients diagnosed with pneumococcal meningitis from 1977 through 2006 and alive 1 yearnafter diagnosis. Data were retrieved from medical databases in Denmark. The absolute and relative risks of all-ncause and cause-specific death were analyzed by using Kaplan-Meier survival curves, Poisson regression anal-nysis, Cox regression analysis, and cumulative incidence functions. The authors identified 2,131 pneumococcalnmeningitis patients and an age- and gender-matched, population-based cohort of 8,524 individuals. Comparednwith the background population, the pneumococcal meningitis patients had an increased long-term mortalitynvarying from an 8-fold increased mortality in the age category 0–<20 years to a 1.5-fold increased mortality innthose aged 60–<80 years. The increased risk of death stemmed from neoplasms, liver diseases, and nervousnsystem diseases. The excessmortality due to neoplasms stemmedmainly from a 5-fold increased risk of death duento hematologic neoplasms. To improve survival in patients surviving the acute phase of pneumococcal meningitis,nphysicians should meticulously screen this patient population for neurologic sequelae and comorbidity predispos-ning to the disease.