Mortality in severe meningococcal disease

Aim-To evaluate mortality of critically ill children admitted with meningoc occal disease. Methods-Prospective study of all children admitted to a regional paediatric intensive care unit (PICU) between January 1995 and March 1998 with mening ococcal disease. Outcome measures were actual overall mortality, predicted mortality (by PRISM), and standardised mortality ratio. Results-A total of 123 children were admitted with meningococcal disease. T here was an overall PICU mortality of 11 children (8.9%). The total mortali ty predicted by PRISM was 24.9. The standardised mortality ratio (SMR) was 0.44. Results were compared with those from four previously published menin gococcal PICU studies (USA, Australia, UK, Netherlands) in which PRISM scor es were calculated. The overall PICU mortality and SMR were lower than thos e in the previously published studies. Conclusion-Compared with older studies and calibrating for disease severity , this study found a decrease in the mortality of critically ill children w ith meningococcal disease.