Division of Pediatric General Medicine, Department of Pediatrics, 38014Chang Gung Memorial Hospital, LinKou Branch, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Graduate Institute of Clinical Medical Sciences, College of Medicine, 56081Chang Gung University, Taoyuan, Taiwan.
J Child Neurol. 2020 Oct;35(11):724-730. doi: 10.1177/0883073820930557. Epub 2020 Jun 8.
Acute encephalitis is an important pediatric emergency that tends to be associated with neurological morbidity, critical illness, and mortality. Few data have specifically focused on evaluating various early clinical parameters in the pediatric emergency department as candidate predictors of mortality. The present retrospective study assessed the clinical, laboratory, and neuroimaging findings of children with acute encephalitis who presented to the emergency department. Of 158 patients diagnosed with encephalitis, 7 (4.4%) had mortality. Compared to the survivors, a multivariate analysis revealed that an initial Glasgow Coma Scale score ≤ 5 (odds ratio [OR]: 8.3, = .022), acute necrotizing encephalitis (OR: 12.1, = .01), white blood count level ≤ 5.2 × 10 cells/L (OR: 28.7, < .001), aspartate aminotransferase level > 35 U/L (OR: 14.3, = .022), and influenza A infection (OR: 7.7, = .027) were significantly associated with mortality. These results indicate that the early recognition of preliminary clinical features and the development of more specific etiologies for encephalitis are important for early treatment strategies.
急性脑炎是一种重要的儿科急症，往往与神经系统发病率、重病和死亡率相关。很少有数据专门针对评估儿科急诊室中各种早期临床参数作为死亡率的候选预测因子。本回顾性研究评估了在急诊就诊的急性脑炎患儿的临床、实验室和神经影像学发现。在诊断为脑炎的 158 名患者中，有 7 名（4.4%）死亡。与幸存者相比，多变量分析显示，初始格拉斯哥昏迷量表评分≤5（优势比[OR]：8.3， =.022）、急性坏死性脑炎（OR：12.1， =.01）、白细胞计数水平≤5.2×10 个细胞/L（OR：28.7， <.001）、天门冬氨酸氨基转移酶水平>35 U/L（OR：14.3， =.022）和甲型流感感染（OR：7.7， =.027）与死亡率显著相关。这些结果表明，早期识别初步临床特征和开发更特异的脑炎病因对于早期治疗策略很重要。
