Datasheet1_Clinical predictors of poor outcome of bacterial meningitis in infants less than 90 days: a systematic review.pdf

Backgroundbacterial meningitis (BM) is more common in infants than at any other time in life and remains a devastating disease with considerable risk of death and morbidity. This article aims to gather the currently available evidence to perform a systematic review of clinical factors that may predict or be associated with BM death and/or sequelae in infants < 90 days of age.
MethodsThe Medline/PubMed, Cochrane Library and Embase databases were systematically searched for prognostic studies that described risk factors for mortality and sequelae in infants aged <90d with BM. The databases were searched from the beginning of the database to December 31st, 2022.The quality of cohort studies was assessed by the Newcastle-Ottawa Scale (NOS). The quality of cross-section studies was assessed by the Agency for Healthcare Research and Quality (AHRQ). A systematic review was undertaken to ascertain the prognostic factors proven to be noteworthy.
ResultsOf the 1,431 studies retrieved, 20 were eligible for the final analysis including 11 cohort and 9 cross-sectional studies were identified. Four risk factors predicting poor outcome were mentioned mostly in those studies, including prematurity or low birth weight (LBW), seizures, coma, and elevated CSF protein. But only preterm, coma and elevated CSF protein were identified by multivariate analyses in more than one study.
ConclusionsThis study demonstrates several potential predictive factors to the poor outcomes of BM in infant. But with large heterogeneity, these predictors should be evaluated by further well-designed prospective studies.
Systematic Review Registrationhttps://www.crd.york.ac.uk/, identifier CRD42017074949.

背景：细菌性脑膜炎（bacterial meningitis，BM）在婴儿群体中的发病率高于人生其他任何阶段，仍是一种兼具高致死率与致残率的灾难性疾病。本文旨在汇总当前可获得的研究证据，针对出生不足90天的婴儿罹患细菌性脑膜炎后与死亡和/或后遗症相关的预测临床因素开展系统综述。
方法：系统检索Medline/PubMed、Cochrane图书馆及Embase数据库，检索时限为各数据库建库起至2022年12月31日，筛选描述出生不足90天的细菌性脑膜炎婴儿死亡与后遗症危险因素的预后研究。采用纽卡斯尔-渥太华量表（Newcastle-Ottawa Scale，NOS）评价队列研究质量，采用美国医疗保健研究与质量局（Agency for Healthcare Research and Quality，AHRQ）量表评价横断面研究质量，最终开展系统综述以明确经证实具有临床意义的预后因素。
结果：共检索获得1431项研究，最终纳入20项符合标准的研究，其中包括11项队列研究与9项横断面研究。多数研究提及4项与不良预后相关的危险因素：早产或低出生体重（low birth weight，LBW）、惊厥、昏迷及脑脊液（cerebrospinal fluid，CSF）蛋白升高。但仅早产、昏迷及脑脊液蛋白升高在多项研究的多因素分析中得到验证。
结论：本研究明确了数项可预测婴儿细菌性脑膜炎不良预后的潜在因素。鉴于各研究间存在较大异质性，上述预测因子尚需通过设计严谨的前瞻性研究进一步评估。
系统综述注册信息：https://www.crd.york.ac.uk/，注册号CRD42017074949。