Background The case fatality rate (CFR) from invasive meningococcal disease (IMD) in New York City (NYC) is greater than national figures, with higher rates among females than males across all age groups. Methods We conducted a retrospective cohort study among 151 persons aged ≥15 years diagnosed with IMD in NYC during 2008-2016 identified through communicable disease surveillance. We examined demographic, clinical, and community-level associations with death to confirm the elevated risk of mortality among female IMD patients after adjusting for confounders and to determine factors associated with female IMD mortality. Relative risks of death were estimated using multivariable log-linear Poisson regression with a robust error variance. Results Females had a higher CFR (n = 23/62; 37%) following IMD than males (n = 17/89; 19%) (adjusted relative risk [aRR], 2.1; 95% confidence interval [CI], 1.2-3.8). Controlling for demographic and clinical factors, there was a significant interaction between sex and fatal outcomes related to meningitis: the relative risk of death for females with meningitis was 13.7 (95% CI, 3.2-58.1) compared with males. In the model restricted to females, altered mental status (aRR, 7.5; 95% CI, 2.9-19.6) was significantly associated with an increased risk of death. Conclusions Female mortality from IMD was significantly increased compared with males, controlling for other predictors of mortality. Sex-based differences in recognition and treatment need to be evaluated in cases of meningococcal disease. Our study highlights the importance of analyzing routine surveillance data to identify and address disparities in disease incidence and outcomes.

中文翻译：

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脑膜炎球菌疾病死亡率的性别差异，纽约，2008-2016年。

背景技术纽约市（NYC）的侵袭性脑膜炎球菌病（IMD）的病死率（CFR）高于全国数字，所有年龄段的女性患病率均高于男性。方法我们对2008年至2016年间在纽约市诊断为IMD的151名年龄≥15岁的人群进行了回顾性队列研究，该人群通过传染病监测确定。我们检查了人口，临床和社区一级与死亡的关联，以确认校正混杂因素后女性IMD患者的死亡风险升高，并确定与女性IMD死亡率相关的因素。使用多变量对数线性泊松回归和强大的误差方差估计相对死亡风险。结果女性IMD后的病死率较高（n = 23/62； 37％），高于男性（n = 17/89； n = 17/89）。19％）（调整后的相对风险[aRR]为2.1； 95％的置信区间[CI]为1.2-3.8）。控制人口统计学和临床​​因素后，性别与与脑膜炎相关的致命结局之间存在显着的相互作用：与男性相比，女性脑膜炎的相对死亡风险为13.7（95％CI，3.2-58.1）。在仅限于女性的模型中，精神状态改变（aRR，7.5； 95％CI，2.9-19.6）与死亡风险增加显着相关。结论与男性相比，IMD引起的女性死亡率显着增加，控制了其他死亡率预测指标。在脑膜炎球菌疾病的情况下，需要评估基于性别的识别和治疗差异。