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Meningite bacteriana em idade pediátrica : sequelas a longo prazo e implicações na qualidade de vida
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Introdução: A meningite bacteriana em idade pediátrica é um importante problema de saúde pública associada a morbimortalidade significativa.
Objetivo: Analisar a morbimortalidade a longo prazo e qualidade de vida em crianças após meningite bacteriana, num hospital terciário da região de Lisboa.
Material e Métodos: Estudo retrospetivo (2007 a 2013) com consulta dos processos clínicos de crianças internadas com meningite bacteriana e realização de inquérito telefónico aos pais, relatando sequelas, qualidade de vida da criança e impacto familiar.
Resultados: Dos 70 doentes internados neste período foi possível analisar os dados de 66. Verificou-se uma incidência de 9,4 casos/ano com idade mediana de 20,6 meses. A maioria apresentava história de doença/internamento recente (56%). O principal agente isolado foi S. pneumoniae. Metade das crianças tiveram internamento na UCIPed e 80% das crianças apresentaram complicações (50% défice neurológico e 45% sépsis/choque séptico). No seguimento (n=34), 53% apresentava algum tipo de sequela a longo prazo, como dificuldade de aprendizagem (47%), alterações do comportamento (32%), défice auditivo (21%), défice visual (21%) e patologia neurológica (15%). Faleceram 3 crianças no internamento e 2 crianças durante o seguimento. A qualidade de vida encontra-se significativamente diminuída a nível do funcionamento escolar. A maioria dos pais entrevistados relata impacto negativo na sua saúde, a nível profissional e financeiro.
Conclusão: A maioria dos sobreviventes de meningite bacteriana encontra-se saudável e a frequentar o ensino regular, mas apresentam mais dificuldades de aprendizagem, alterações do comportamento, défice auditivo e visual, associados a impacto na qualidade de vida da criança e da família.
Introduction: Bacterial meningitis in children is an important public health problem, related to significant mortality and morbidity rates. Objectives: Analyze long-term morbimortality and quality of life of children diagnosed with bacterial meningitis in a level III hospital in Lisbon. Material e Methods: Retrospective review of clinical data of children admitted with bacterial meningitis from January 2007 until December 2013. A telephonic questionnaire was answered by the parents, regarding sequelae, quality of life and family impact. Results: Of the 70 children admitted in this period, only 66 clinical files were available. The mean incidence was 9,4 cases/year with an average age of 20,6 months. About 56% had history of recent illness or hospital admission. The predominant agent was S. pneumoniae. Half the children were admitted to the ICU and 80% had complications (50% neurological deficit and 45% sepsis/septic shock). During follow-up, 53% had at least one sequelae, like learning disability (47%), behavioral problems (32%), hearing loss (21%), visual impairment (21%) and neurological deficit (15%). Three children died during the hospital stay and 2 during follow-up. The quality of life was affected, with a greater impact in school and emotional scores. The majority of parents reported a negative impact in the family professional status, finances and health. Conclusion: The majority of bacterial meningitis survivors are now healthy and attend regular school, but have more learning disabilities, behavioral problems, hearing and visual impairment, which affects they’re quality of life, as well as of the whole family
Introduction: Bacterial meningitis in children is an important public health problem, related to significant mortality and morbidity rates. Objectives: Analyze long-term morbimortality and quality of life of children diagnosed with bacterial meningitis in a level III hospital in Lisbon. Material e Methods: Retrospective review of clinical data of children admitted with bacterial meningitis from January 2007 until December 2013. A telephonic questionnaire was answered by the parents, regarding sequelae, quality of life and family impact. Results: Of the 70 children admitted in this period, only 66 clinical files were available. The mean incidence was 9,4 cases/year with an average age of 20,6 months. About 56% had history of recent illness or hospital admission. The predominant agent was S. pneumoniae. Half the children were admitted to the ICU and 80% had complications (50% neurological deficit and 45% sepsis/septic shock). During follow-up, 53% had at least one sequelae, like learning disability (47%), behavioral problems (32%), hearing loss (21%), visual impairment (21%) and neurological deficit (15%). Three children died during the hospital stay and 2 during follow-up. The quality of life was affected, with a greater impact in school and emotional scores. The majority of parents reported a negative impact in the family professional status, finances and health. Conclusion: The majority of bacterial meningitis survivors are now healthy and attend regular school, but have more learning disabilities, behavioral problems, hearing and visual impairment, which affects they’re quality of life, as well as of the whole family
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2016
Palavras-chave
Meningite bacteriana Crianças Complicações Sequelas neurológicas Qualidade de vida Família