Exploring factors influencing adverse prognosis in children with acute encephalitis/ encephalopathy

doi:10.3969/j.issn.1004-583X.2022.11.010

Abstract

Abstract:

Objective To explore the prognostic factors in children with acute encephalitis/encephalopathy (AE). Methods Retrospective analysis was made on the clinical data and adverse prognosis of children clinically diagnosed as AE in the pediatrics department of Fujian Maternal and Child Health Hospital from June 1, 2018 to May 30, 2021. The following conditions were found at the time of discharge: hospital death, tracheotomy, gastroenteric tube feeding, rehabilitation treatment, and intractable epilepsy. Multivariate Logistic regression was used to analyze the factors influencing the adverse prognosis of AE.Results Among 105 children with AE included in the study, 34 (32.4%) had adverse outcomes, including 5 (4.8%) hospital deaths. Multivariate Logistic regression analysis showed that long duration of fever (>5 days), ≥ 3 seizures, respiratory failure, and combined organ dysfunction were the risk factors for adverse prognosis of AE. Conclusion Long duration of fever (>5 days), ≥ 3 seizures, respiratory failure, and organ dysfunction are closely related to the poor prognosis of AE. Early detection of high-risk children and timely intervention can improve the prognosis of children with AE.

Key words: encephalitis, viral, brain diseases, child, viral, prognosis

CLC Number:

R512.3

Wang Xiaoqin, Zhou Youfeng, Lin Binrong. Exploring factors influencing adverse prognosis in children with acute encephalitis/ encephalopathy[J]. Clinical Focus, 2022, 37(11): 1017-1020.

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URL: https://huicui.hebmu.edu.cn/EN/10.3969/j.issn.1004-583X.2022.11.010

https://huicui.hebmu.edu.cn/EN/Y2022/V37/I11/1017

Figures/Tables 3

临床表现	例(%)
发热	98(93.3)
头痛	52(49.5)
惊厥	47(44.8)
意识障碍	44(41.9)
呕吐	40(38.1)
精神行为异常	29(27.6)
前囟隆起	6(5.7)

组别	例数		性别				年龄			入住PICU				发热持续时间
组别	例数		男		女		<3岁	≥3岁		否		是		≤5天		>5天
预后良好组	71		43(60.6)		28(39.4)		30(42.3)	41(57.7)		56(78.9)		15(21.1)		46(64.8)		25(35.2)
预后不良组	34		23(67.6)		11(32.4)		14(41.2)	20(58.8)		7(20.6)		27(79.4)		15(44.1)		19(55.9)
χ²值			0.890				0.010			10.539				4.117
$P$ 值			0.347				0.918			0.002				0.045
组别		例数		惊厥发作次数					呼吸衰竭				合并脏器功能损伤
组别		例数		<3次或无		≥3次			无		有		无		有
预后良好组		71		45(63.4)		26(36.6)			53(74.6)		18(25.4)		61(85.9)		10(14.1)
预后不良组		34		12(35.3)		22(64.7)			21(61.8)		13(38.2)		22(64.7)		12(35.3)
χ²值				7.705					5.309				11.384
$P$ 值				0.007					0.023				0.001

组别	例数		性别				年龄			入住PICU				发热持续时间
组别	例数		男		女		<3岁	≥3岁		否		是		≤5天		>5天
预后良好组	71		43(60.6)		28(39.4)		30(42.3)	41(57.7)		56(78.9)		15(21.1)		46(64.8)		25(35.2)
预后不良组	34		23(67.6)		11(32.4)		14(41.2)	20(58.8)		7(20.6)		27(79.4)		15(44.1)		19(55.9)
χ²值			0.890				0.010			10.539				4.117
$P$ 值			0.347				0.918			0.002				0.045
组别		例数		惊厥发作次数					呼吸衰竭				合并脏器功能损伤
组别		例数		<3次或无		≥3次			无		有		无		有
预后良好组		71		45(63.4)		26(36.6)			53(74.6)		18(25.4)		61(85.9)		10(14.1)
预后不良组		34		12(35.3)		22(64.7)			21(61.8)		13(38.2)		22(64.7)		12(35.3)
χ²值				7.705					5.309				11.384
$P$ 值				0.007					0.023				0.001

因素	回归系数	标准误	Waldχ²值	$P$ 值	$O R$ 值	95% $C I$
因素	回归系数	标准误	Waldχ²值	$P$ 值	$O R$ 值	下限	上限
发热持续时间>5天	0.564	0.187	3.009	0.030	6.115	1.256	13.569
惊厥发作≥3次	0.657	0.138	4.022	0.014	4.531	2.705	11.207
合并呼吸衰竭	0.233	0.212	2.018	0.044	2.101	1.022	6.648
合并脏器功能损伤	0.285	0.261	3.017	0.022	1.010	1.008	7.341

因素	回归系数	标准误	Waldχ²值	$P$ 值	$O R$ 值	95% $C I$
因素	回归系数	标准误	Waldχ²值	$P$ 值	$O R$ 值	下限	上限
发热持续时间>5天	0.564	0.187	3.009	0.030	6.115	1.256	13.569
惊厥发作≥3次	0.657	0.138	4.022	0.014	4.531	2.705	11.207
合并呼吸衰竭	0.233	0.212	2.018	0.044	2.101	1.022	6.648
合并脏器功能损伤	0.285	0.261	3.017	0.022	1.010	1.008	7.341

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