Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Dec 31;18(1):2021764.
doi: 10.1080/21645515.2021.2021764. Epub 2022 Feb 22.

Care pathways in invasive meningococcal disease: a retrospective analysis of the French national public health insurance database

Catherine Weil-Olivier  1 , Muhamed-Kheir Taha  2 , Stéphane Bouée  3 , Corinne Emery  3 , Véronique Loncle-Provot  4 , Gaëlle Nachbaur  4 , Ekkehard Beck  5 , Céline Pribil  4
Affiliations

Care pathways in invasive meningococcal disease: a retrospective analysis of the French national public health insurance database

Catherine Weil-Olivier et al. Hum Vaccin Immunother. .

Abstract

Invasive meningococcal disease (IMD) carries a high burden in terms of mortality, long-term complications, and cost, which can be significantly reduced by vaccination. The objectives of this case-control study were to document the care pathways of patients with IMD before, during, and after hospitalization and to assess in-hospital complications and long-term sequelae. Cases consisted of all people hospitalized for IMD in France between 2012 and 2017. Controls were matched by age, gender, and district of residence. Data were extracted from the French national public health insurance database on demographics, hospitalizations, mortality and potential sequelae of IMD. Overall, 3,532 cases and 10,590 controls were assessed and followed up for 2.8 years (median). During hospitalization, 1,577 cases (44.6%) stayed in an intensive care unit, 1,238 (35.1%) required mechanical ventilation, and 43 (1.2%) underwent amputation; 293 cases (8.3%) died in hospital and a further 163 (4.6%) died following discharge; 823 cases (25.4% of survivors) presented ≥1 sequela and 298 (9.2%) presented multiple sequelae. The most frequently documented sequelae were epilepsy (N = 205; 5.8%), anxiety (N = 196; 5.5%), and severe neurological disorders (N = 193; 5.5%). All individual sequelae were significantly more frequent (p < .0001) in cases than controls. Hearing/visual impairment and communication problems were conditions that presented the highest risk for cases compared to controls (risk ratios >20 in all cases). In conclusion, this study highlights the importance of providing optimal medical care for patients with IMD, of minimizing the delay before hospitalization, and of effective prevention through comprehensive vaccination programs.

Keywords: France; Invasive meningococcal disease; care pathways; health insurance database; mortality; sequelae.

Plain language summary

Benefits of providing optimal medical care for IMD patients.Importance of minimising the delay before hospitalization.IMD remains challenging to diagnose, and vaccination is the most efficient way to prevent the disease and its complications.

PubMed Disclaimer

Conflict of interest statement

CP, EB, GN, and VL-P are employed by the GSK group of companies. EB and GN hold shares in the GSK group of companies. CW-O received honoraria for lectures from the GSK group of companies and from AstraZeneca, MedImmune, Pfizer, Sanofi-Pasteur, Seqirus outside of the presented work. M-KT reported his institution received fees from the GSK group of companies for the work presented here and from the GSK group of companies, Pfizer and Sanofi-Pasteur for activities outside the presented work. M-KT reported a patent (630133) issued. SB and CE reported that their institution (CEMKA) received grants from the GSK group of companies to perform the study related to the present publication. All authors declare no other financial and non-financial relationships and activities.

Figures

Figure 1.
Figure 1.
Patient trajectory for management of invasive meningococcal disease. For one patient, discharge destination was unknown.
Figure 2.
Figure 2.
Mortality risk as a function of age in survivors. Hazard ratios for mortality (excluding death during the index hospitalization) in cases compared to controls are presented with their 95% confidence interval.
Figure 3.
Figure 3.
Sequelae of interest. Data are presented as a Forest plot illustrating the risk ratios for the occurrence of each type of sequela between cases and controls, with their 95% confidence intervals (95% CI).
Figure 4.
Figure 4.
Graphical plain language summary.
See this image and copyright information in PMC

References

    1. Feldman C, Anderson R.. Meningococcal pneumonia: a review. Pneumonia (Nathan). 2019;11:3. doi: 10.1186/s41479-019-0062-0. - DOI - PMC - PubMed
    1. Nadel S, Ninis N. Invasive meningococcal disease in the vaccine era. Front Pediatr. 2018;6:321. doi: 10.3389/fped.2018.00321. - DOI - PMC - PubMed
    1. Stephens DS. Neisseria meningitidis. Infect Control. 1985;6:37–11. doi: 10.1017/S0195941700062482. - DOI - PubMed
    1. Whittaker R, Dias JG, Ramliden M, Kodmon C, Economopoulou A, Beer N, Pastore Celentano L, Kanitz E, Richter L, Mattheus W, et al. The epidemiology of invasive meningococcal disease in EU/EEA countries, 2004-2014. Vaccine. 2017;35:2034–41. doi: 10.1016/j.vaccine.2017.03.007. - DOI - PubMed
    1. Jafri RZ, Ali A, Messonnier NE, Tevi-Benissan C, Durrheim D, Eskola J, Fermon F, Klugman KP, Ramsay M, Sow S, et al. Global epidemiology of invasive meningococcal disease. Popul Health Metr. 2013;11:17. doi: 10.1186/1478-7954-11-17. - DOI - PMC - PubMed

Publication types

Substances