Abstract：
OBJECTIVE: A low Glasgow Coma Scale Score (GCS) on admission is a known predictor of poor outcome from childhood bacterial meningitis. In turn, the factors associated with the admission GCS are less known. Our aim was to identify them, both for clinical alerts of reserved prognosis and to find potential targets for intervention.
METHODS: This study is a secondary analysis of data collected prospectively in Angola and in Latin America between 1996 and 2007. Children with bacterial meningitis were examined on hospital admission and their GCS was assessed using the age-adjusted scale. Associations between on-admission GCS and host clinical factors were examined.
RESULTS: A total of 1376 patients with confirmed bacterial meningitis were included in the analysis (609 from Latin America and 767 from Angola). The median GCS was 13 for all patients (12 in Angola and 13 in Latin America). In the multivariate analysis, in the areas combined, seizures, focal neurological signs, and pneumococcal aetiology associated with GCS <13, as did treatment delay in Latin America.
CONCLUSIONS: Besides pneumococcal aetiology, we identified characteristics, easily registrable on admission, which are associated with a low GCS in childhood bacterial meningitis. Of these, expanding pneumococcal vaccinations and treatment delays could be modified.
METHODS: This study is a secondary analysis of data collected prospectively in Angola and in Latin America between 1996 and 2007. Children with bacterial meningitis were examined on hospital admission and their GCS was assessed using the age-adjusted scale. Associations between on-admission GCS and host clinical factors were examined.
RESULTS: A total of 1376 patients with confirmed bacterial meningitis were included in the analysis (609 from Latin America and 767 from Angola). The median GCS was 13 for all patients (12 in Angola and 13 in Latin America). In the multivariate analysis, in the areas combined, seizures, focal neurological signs, and pneumococcal aetiology associated with GCS <13, as did treatment delay in Latin America.
CONCLUSIONS: Besides pneumococcal aetiology, we identified characteristics, easily registrable on admission, which are associated with a low GCS in childhood bacterial meningitis. Of these, expanding pneumococcal vaccinations and treatment delays could be modified.
摘要：
目的：入院时格拉斯哥昏迷评分（GCS）较低是儿童细菌性脑膜炎预后不良的已知预测指标。反过来,与入院GCS相关的因素鲜为人知.我们的目的是识别它们，既用于保留预后的临床警报，也用于寻找潜在的干预目标。
方法：本研究是对1996年至2007年在安哥拉和拉丁美洲前瞻性收集的数据的二次分析。入院时对细菌性脑膜炎患儿进行检查，并使用年龄校正量表评估其GCS。研究了入院时GCS与宿主临床因素之间的关联。
结果：共有1376例确诊的细菌性脑膜炎患者纳入分析（609例来自拉丁美洲，767例来自安哥拉）。所有患者的GCS中位数为13（安哥拉12例，拉丁美洲13例）。在多变量分析中，在合并的地区，癫痫发作,局灶性神经体征,与GCS<13相关的肺炎球菌病因，拉丁美洲的治疗延迟也是如此。
结论：除肺炎球菌病因外，我们确定了特征，入学时很容易注册，这与儿童细菌性脑膜炎的低GCS有关。其中,扩大肺炎球菌疫苗接种和治疗延误是可以改变的.
方法：本研究是对1996年至2007年在安哥拉和拉丁美洲前瞻性收集的数据的二次分析。入院时对细菌性脑膜炎患儿进行检查，并使用年龄校正量表评估其GCS。研究了入院时GCS与宿主临床因素之间的关联。
结果：共有1376例确诊的细菌性脑膜炎患者纳入分析（609例来自拉丁美洲，767例来自安哥拉）。所有患者的GCS中位数为13（安哥拉12例，拉丁美洲13例）。在多变量分析中，在合并的地区，癫痫发作,局灶性神经体征,与GCS<13相关的肺炎球菌病因，拉丁美洲的治疗延迟也是如此。
结论：除肺炎球菌病因外，我们确定了特征，入学时很容易注册，这与儿童细菌性脑膜炎的低GCS有关。其中,扩大肺炎球菌疫苗接种和治疗延误是可以改变的.
