Guanghui Zheng,1– 3 Yijun Shi,1– 3 Jialu Sun,1 Siqi Wang,1 Lingye Qian,4 Hong Lv,1– 3 Guojun Zhang,1– 3 Kelin Chen1– 3 

1Clinical Laboratory of Beijing Tiantan Hospital, Capital Medical University, Beijing, People’s Republic of China; 2NMPA Key Laboratory for Quality Control of in vitro Diagnostics, Beijing, People’s Republic of China; 3Beijing Engineering Research Center of Immunological Reagents Clinical Research, Beijing, People’s Republic of China; 4Clinical Laboratory of Beijing Anzhen Hospital, Capital Medical University, Beijing, People’s Republic of China

Correspondence: Guojun Zhang; Kelin Chen, Clinical Laboratory of Beijing Tiantan Hospital, Capital Medical University, NO. 119 Nansihuan West Road, Fengtai District, Beijing, People’s Republic of China, Tel +86 15811219411 ; +86 13810876107, Email zgjlunwen@163.com; chenkelin214316@163.com

Aim: To express the clinical characteristics of patients with post-neurosurgical meningitis (PNM) and launch a survival analysis to screen mortality predictors.
Methods: A cohort analysis containing more than 70000 patients was evaluated, and all of them received neurosurgical procedure. Clinical and microbial epidemiology, therapy and mortality of PNM patients were reviewed. Multi-variable Cox proportional hazard models were applied to achieve survival analysis.
Results: About 900 PNM patients from 3244 cases were selected for characteristics and survival analysis, the mean age of them was 41 (27– 54) years, 516 (57.3%) were men and 384 (42.7%) were women. The 28-day mortality was 12.4% (112 of 900) in patients with PNM. Hypertension, external ventricular drainage (EVD), and lumbar drainage (LD) are mortality predictors for PNM, with a hazard ratio (HR) of 2.641 (95% C.I. 1.563– 4.464, P< 0.001), 2.196 (95% C.I. 1.317– 3.662, P=0.003), and 1.818 (95% C.I. 1.126– 2.936, P=0.014). In treatment, the outcome of patients receiving three or more antibiotic combinations is better than that of patients receiving dual-drug combinations.
Conclusion: The mortality of patients with PNM was relatively high, and the risk factors related to 28-days mortality were hypertension, EVD and LD and treatment with three or more antibiotics are much better.

Keywords: Post-neurosurgical meningitis, survival analysis, mortality, characteristics, treatment