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首页> 外文期刊>Journal of the American Geriatrics Society >Healthcare‐Associated Meningitis or Ventriculitis in Older Adults
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Healthcare‐Associated Meningitis or Ventriculitis in Older Adults

机译：老年人的医疗保健脑膜炎或脑室炎

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Background/Objectives Healthcare‐associated meningitis or ventriculitis ( HCAMV ) is a serious and life‐threatening complication of invasive neurosurgical procedures or penetrating head trauma. Older adults are at higher risk of adverse outcomes in community‐acquired meningitis but studies of HCAMV are lacking. Therefore, we perform the study to define the differences in clinical outcomes between older and younger adults with HCAMV. Design Retrospective study. Setting A large tertiary care hospital in Houston, Texas, from July 2003 to November 2014. Participants Adults with a diagnosis of HCAMV (N = 160) aged ≥65 (n = 35), aged 18–64 (n = 125). Measurements Demographic characteristics, clinical presentation, laboratory results, treatments, and outcomes (Glasgow Outcome Scale). Results Older adults had more comorbidities and CSF abnormalities [pleocytosis, high cerebrospinal fluid ( CSF ) protein, low CSF glucose) and were more likely to have altered mental status than younger adults ( P .05). An adverse clinical outcome was seen in 142 participants (89%) (death (n = 18, 11%), persistent vegetative state (n = 26, 16%), severe disability (n = 68, 43%), moderate disability (n = 30, 19%). There was no difference in adverse outcomes between older (97%) and younger (86%) adults ( P = .13). On logistic regression analysis, abnormal neurological examination (adjusted odds ratio ( aOR ) = 7.13, 95% confidence interval ( CI ) = 2.15–23.63, P = .001) and mechanical ventilation ( aOR = 11.03, 95% CI = 1.35–90.51, P = .02) were associated with adverse clinical outcomes. Conclusion Older adults with HCAMV have more comorbidities and CSF abnormalities and are more likely to have altered mental status than younger adults but have similar high rates of adverse clinical outcomes.
机译：背景/目标医疗相关脑膜炎或脑室（HCAMV）是微创神经外科手术或穿透头部外伤严重和危及生命的并发症。老年人都在社区获得性脑膜炎，但是HCAMV的研究缺乏的不利结果的风险较高。因此，我们进行研究，以确定在老年人和年轻的成年人与HCAMV之间临床结果的差异。设计回顾性研究。设置在休斯敦，得克萨斯州，一个大的三级医院从2003年7月2014年11月参加成年人HCAMV诊断（N = 160）年龄≥65（N = 35），18-64岁（N = 125）。测量人口特征，临床表现，实验室检查结果，治疗和预后（格拉斯哥预后评分）。结果老年人合并症更多和CSF异常[细胞增多，高脑脊液（CSF）的蛋白质，低CSF葡萄糖）和更可能具有改变的比年轻的成年人（P＆LT精神状态; 0.05）。产生不利的临床结果被认为在142名参加者（89％）（死亡（N = 18，11％），持续性植物人状态（N = 26，16％），重度残疾（N = 68，43％），中度残疾（ n = 30的19％），但较老之间在不良结果没有差异（97％）和年轻（86％）的成人（P = 0.13）。在对数回归分析，神经系统检查异常（校正的比值比（AOR） = 7.13，95％置信区间（CI）= 2.15-23.63，P = 0.001）和机械通气（AOR = 11.03，95％CI = 1.35-90.51，P = 0.02）与不良临床结果相关联。结论旧版与HCAMV成年人有更多的合并症和脑脊液异常，更有可能已经改变了比年轻的成年人的心理状态，但有不良的临床结果类似的高利率。

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