Outcomes of Invasive Meningococcal Disease in Adults and Children in Canada Between 2002 and 2011: A Prospective Cohort Study

Background. Neisseria meningitidis causes 500 000 cases of septicemia and meningitis worldwide annually, with approximately 200 cases in Canada each year. Previous studies describe a case-fatality rate of 5%–15 % and up to 20% of survivors suffering from long-term disability. Methods. This study was performed in Canada between 2002 and 2011; the study area included>50 % of the coun-try’s population. We identified risk factors associated with death and the development of complications in children and adults admitted to hospital with confirmed invasive meningococcal disease (IMD). Clinical information was obtained from hospital records. Risk factors for death and complications were analyzed by univariate and multivariable analyses. Results. Of 868 individuals hospitalized with IMD, there were 73 deaths (8.4%) and 157 (18%) developed compli-cations. The most common complications were hearing loss (5.4%), skin scarring (5.4%), amputation (3.4%), renal dysfunction (2.6%), and seizures (2.5%). Mortality was independently associated with shock (adjusted odds ratio [aOR], 23.30; P <.0001), age (aOR, 1.02 per 1-year increased age; P <.0001), symptom onset within 24 hours of ad-mission (aOR, 1.80; P =.0471), and admission to the intensive care unit (aOR, 0.41; P =.0196). Development of com-plications was independently associated with seizures (aOR, 4.55; P <.0001), shock (aOR, 3.10; P <.0001), abnorma