Risk factors of death in children with bacterial meningitis: a systematic review and meta-analysis

Background and objectives. To identify the risk factors that cause death in children with bacterial meningitis. Materials and methods. Articles were obtained through a journal literature search of observational studies using electronic databases: PubMed, Scopus, ProQuest, Science Direct, and Web of Science. The articles were systematically selected using international guidelines from the Preferred Reporting Items for Systematic Reviews and Meta-analysis Protocols. Results. A literature search identified 8746 articles. After screening, 19 studies were found that met the requirements for meta-analysis. There was a total of 6997 patients aged 1 month to 18 years who were included in the study. Factors that significantly influence the risk of death in children with bacterial meningitis in this meta-analysis are: age less than five years (pooled OR = 3,19; 95% CI, 1,03-9,89; p = 0.04), age less than three years (pooled OR = 18,77; 95% CI, 2,10-167,83; p = 0.009), decreased of consciousness (pooled OR = 4,85; 95% CI, 1,25-18,86; p = 0.02), seizure (pooled OR = 2,97; 95% CI, 1,09-8,07; p = 0,03), and bacteria Streptococcus pneumoniae compared to Haemophilus influenzae from culture of cerebrospinal fluid (pooled OR = 12,52; 95% CI, 8,95-17,52; p <0,00001). Conclusions. Risk factors for death in children with bacterial meningitis were age less than five years old, age less than three years, decrease of consciousness, seizure, and cerebrospinal fluid culture result of bacteria Streptococcus pneumoniae compared to bacteria Haemophilus influenzae.