ArticleThe Lancet regional health. Europe2026
Outcomes, prognostic factors, and the role of intracranial pressure monitoring in severe community-acquired bacterial meningitis: a multicenter retrospective cohort study.
Article in The Lancet regional health. Europe, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
2 citing papers in PubMed.
- Beyond the ICP value: neurocritical care in severe bacterial meningitis-authors' reply.The Lancet regional health. Europe · 2026Article
- Beyond the ICP value: neurocritical care in severe bacterial meningitis.The Lancet regional health. Europe · 2026Article
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Authors and funding
30 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Community-acquired bacterial meningitis remains associated with high mortality and neurological disability in critically ill adults. Contemporary data on outcomes in mechanically ventilated patients and on the role of invasive intracranial pressure monitoring are limited. We aimed to describe 90-day outcomes, identify predictors of unfavorable neurological outcome, and evaluate the association between invasive intracranial pressure monitoring and prognosis in mechanically ventilated adults with community-acquired bacterial meningitis. Methods: Retrospective multicenter cohort study (2012-2023) across 26 French ICUs. The primary endpoint was unfavorable functional outcome at day 90 (modified Rankin Scale score 3-6), assessed using multivariable mixed-effects regression and propensity score-based overlap weighting. Findings: Among 704 included patients (median age, 66 years [IQR, 48-70 years]; 421 men [59.8%]), 354 (50.3%) had an unfavorable outcome at day 90, including 220 (31.3%) who died. Independent predictors of unfavorable outcome included older age, septic shock, acute kidney injury, coagulation disorders, lower motor score on the Glasgow Coma Scale, pupillary abnormalities, and abnormal brain imaging findings at presentation. Appropriate initial antimicrobial therapy, along with adjunctive dexamethasone, was associated with improved outcomes. Invasive intracranial pressure monitoring was performed in 84/704 patients (11.9%) and was not associated with improved functional outcome in the overall cohort (odds ratio, 0.97; 95% CI, 0.48-1.96) or in prespecified subgroups. Interpretation: In this large real-world cohort, 90-day mortality and disability remain high and are largely driven by initial neurological and systemic severity. Invasive intracranial pressure monitoring was not associated with improved outcomes, and no clear benefit was identified in this observational analysis. Funding: None.
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