Prediction in meningococcal disease: A literature review

Abstract

Meningococcal disease is a global burden with an estimated annual death rate of 170000 worldwide. The disease has an overall mortality greater than 10%. Despite these figures, several studies demonstrate that the management of children with severe meningococcal sepsis and septic shock is suboptimal. Most children received inadequate fluid resuscitation and inotropic support during their admission. Hence, this paper presents a review of relevant literature of prediction studies and discusses clinical and methodological issues, which may have influenced the results. It concludes that several studies have investigated the predictors of a poor clinical outcome in this condition, but there is a lack of studies that consider prediction of fluid and inotrope requirements as an outcome measure. The identification of such predictors would allow treatment to be directed to those children most likely to benefit, with a long term goal of improving patient outcome.