Abstract
Invasive meningococcal disease (IMD) is life-threatening and associated with substantial morbidity and mortality. Currently, few data published regarding the consequences of IMD. The study aimed to assess the clinical and economic burdens of IMD in France. A retrospective database analysis was conducted. Patients admitted to hospitals due to IMD between 2014 and 2016 were selected from the French hospital discharge database (PMSI). Demographics, clinical outcomes and health utilization (HRU) during the initial IMD related hospitalization (index hospitalization) were descriptively analysed. A generalized linear model with a gamma distribution was applied to examine 1-year HRU costs after index hospitalization adjusting for age, type of IMD and presence of sequelae at index hospitalization. A total of 1,344 patients were identified. About 30% cases were in children < 5 years old and 25% aged 10-24 years. Majority of patients presented as meningococcal meningitis (59%), 25% as meningococcaemia, and 9% both. The case fatality rate at IMD related initial hospitalization (index hospitalization) was 6% and 14% survivors had any type of sequelae. Of these, 8% had neurological sequelae followed by amputation/ skin necrosis (3%) and auditive impairment (2%). The median index hospitalisation stay was 9 days (Q1-Q3: 7-13 days) with ICU admission rate at 45%. The median index hospitalisation cost was 7,961€ (IQR: 5,365€-12,632€). Patients with both types of IMD costed the most (Median: 10,478€). Results of 1-year direct medical cost from the generalized model indicated that patients with at least one sequela, with both of IMD, or aged 25 years and older were statistically significantly associated with higher costs than others. IMD is unpredictable and can occur in all age. The study highlights the severity and high short and long-term health and economic burdens associated with the disease. The data underlines the importance of prevention against IMD through vaccination.
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