Predictors of 90-day Readmissions in Adults with Bacterial Meningitis

Abstract

Background: Bacterial meningitis is associated with high neurological morbidity, mortality, and cost. A large part of these outcomes can be associated with hospital readmission. However, little is known about the factors influencing readmissions following bacterial meningitis. The objective of this study is to examine rates of 90-day readmissions, factors associated with readmission, and the cost associated with bacterial meningitis.
Methods: In this retrospective cohort study, we examined adults hospitalized with a diagnosis of bacterial meningitis using the Nationwide Readmissions Database (NRD) during 2016 and 2017. We used a survey-weighted logistic regression models to determine the adjusted odds ratios (aOR) and 95% confidence intervals (95% CI) for risk factors associated with readmission within 90 days of index discharge.
Results: Among the 10,922 survivors of bacterial meningitis included in this study, 28.9% (n = 3158) were readmitted within 90 days. The majority of cases had an unknown etiology of their bacterial meningitis (54.5%, n = 5955), followed by Streptococcus pneumoniae (14.3%), streptococcal (12.4%), and staphylococcal (10.6%) meningitis. On multivariate analysis, patients with staphylococcal meningitis (aOR: 1.88; 95% CI: 1.45 – 2.44) and an unknown etiology (aOR: 1.30; 95% CI: 1.06 – 1.59) were significantly more likely to be readmitted in 90 days, as were patients with renal disease, metastatic cancer, and anemia.
Conclusion: Bacterial meningitis has high rates of readmission, with more than one in four patients being readmitted within 90 days of discharge. Further investigation into why patients with an unknown bacterial etiology of their meningitis is warranted.