Work

Development and validation of a predictive model for 30-day mortality in adult bacterial meningitis: a retrospective cohort study

Year: 2025

Type: article

Abstract: Background: Bacterial meningitis continues to carry significant mortality despite advances in antimicrobial therapy. Early identification of high-risk patients remains challenging in clinical practice. Methods: = 83) cohorts. Comprehensive clinical parameters, laboratory findings (including cerebrospinal fluid analysis), and microbiological data were collected. Least Absolute Shrinkage and Selection Operator (LASSO) regression and multivariable regression were used to construct a predictive nomogram. Model performance was assessed by area under the receiver operating characteristic curve (AUC), calibration plots, and decision curve analysis. Results: The overall 30-day mortality rate was 29.2% (81/277). In multivariate analysis, five independent predictors emerged: age [hazard ratio (HR) 1.04, 95% confidence interval (CI): 1.01-1.08], neurological complications (HR 2.31, 95% CI: 1.12-4.78), multidrug-resistant (MDR) infection (HR 3.15, 95% CI: 1.42-6.99), cerebrospinal fluid neutrophil percentage (HR 1.03, 95% CI: 1.01-1.05), and serum C-reactive protein (HR 1.12, 95% CI: 1.03-1.22). The nomogram demonstrated good discrimination with AUCs of 0.851 (95% CI: 0.793-0.909) in the training cohort and 0.814 (95% CI: 0.715-0.914) in validation. Decision curve analysis confirmed clinical utility across a wide probability threshold range. Conclusion: Our validated prediction model incorporating readily available clinical and laboratory parameters provides accurate risk stratification for adult bacterial meningitis patients. This tool may assist clinicians in identifying high-risk individuals who could benefit from more intensive monitoring and treatment strategies.

Source: Frontiers in Medicine

DOI: 10.3389/fmed.2025.1692631

Authors: Jun Zhou, Jicheng Xing, Xiangjun Cheng, Fei Jin, Yiling Huang

Institutions: Jiangsu Province Hospital, Nanjing Medical University, Nanjing General Hospital of Nanjing Military Command, Nanjing University

Language: English

Topic: Bacterial Infections and Vaccines

Subfield: Microbiology

Field: Immunology and Microbiology

Domain: Life Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,801