CLINICAL RESEARCH
Blood-brain barrier damage as a predictor of outcome in patients with purulent meningitis
Submission date: 2018-02-11
Final revision date: 2018-03-12
Acceptance date: 2018-04-06
Publication date: 2018-04-30
Arch Med Sci Civil Dis 2018;3(1):26-33
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Purulent meningitis is a severe infection of the central nervous system caused by different bacteria and very often causes severe complications and high lethality. Since the disease still has unclear pathogenesis and high mortality, researchers and clinicians are focused on the influence of damage of the blood-brain barrier (BBB) and its subsequent impact on the outcome of purulent meningitis. The aim of this study was to investigate the albumin concentration and the albumin coefficient as the best parameters of BBB damage, and their influence on the outcome of patients with purulent meningitis.
Material and methods:
The study was carried out by examining the hospitalized patients in the Clinic of Infective Diseases in Prishtina, Kosovo. Blood-brain barrier damage is evaluated by analyzing the dynamics of values of proteins, glucose and albumins, as well as by determining the BBB coefficient of damage.
Results:
The data consistent with BBB damage in patients with purulent meningitis corresponded with disease outcome. Consequently, 56.97% of the patients who developed complications or died had very severe BBB damage. Patients with the mean value of albumin coefficient X = 46.5 ±27.23 g/l were at higher risk of developing complications (relative risk (RR) = 2.63; p < 0.0001) or having a lethal outcome (RR = 5.20; p < 0.0001). Patients with longer duration of pathological mean values of albumin coefficient were at higher risk of developing complications (RR = 3.11; p < 0.0001).
Conclusions:
Our data suggest that BBB damage in patients with purulent meningitis correspond with disease outcome. The best predictors for outcome were albumin coefficient and albumin concentration in cerebrospinal fluid.
Purulent meningitis is a severe infection of the central nervous system caused by different bacteria and very often causes severe complications and high lethality. Since the disease still has unclear pathogenesis and high mortality, researchers and clinicians are focused on the influence of damage of the blood-brain barrier (BBB) and its subsequent impact on the outcome of purulent meningitis. The aim of this study was to investigate the albumin concentration and the albumin coefficient as the best parameters of BBB damage, and their influence on the outcome of patients with purulent meningitis.
Material and methods:
The study was carried out by examining the hospitalized patients in the Clinic of Infective Diseases in Prishtina, Kosovo. Blood-brain barrier damage is evaluated by analyzing the dynamics of values of proteins, glucose and albumins, as well as by determining the BBB coefficient of damage.
Results:
The data consistent with BBB damage in patients with purulent meningitis corresponded with disease outcome. Consequently, 56.97% of the patients who developed complications or died had very severe BBB damage. Patients with the mean value of albumin coefficient X = 46.5 ±27.23 g/l were at higher risk of developing complications (relative risk (RR) = 2.63; p < 0.0001) or having a lethal outcome (RR = 5.20; p < 0.0001). Patients with longer duration of pathological mean values of albumin coefficient were at higher risk of developing complications (RR = 3.11; p < 0.0001).
Conclusions:
Our data suggest that BBB damage in patients with purulent meningitis correspond with disease outcome. The best predictors for outcome were albumin coefficient and albumin concentration in cerebrospinal fluid.
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| ISSN: | 2451-0637 |
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