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印度西部急性脑炎综合征住院患者的人口统计学特征、病因及临床结局研究

Study of Demographic Profile, Etiology, and Clinical Outcome in Patients Admitted With Acute Encephalitis Syndrome From the Western Part of India.

作者信息

Roy Dhara B, Khatri Harsh V

机构信息

Medicine, Smt. Nathiba Hargovandas Lakhmichand Municipal Medical College (NHLMMC), Ahmedabad, IND.

出版信息

Cureus. 2022 Mar 11;14(3):e23085. doi: 10.7759/cureus.23085. eCollection 2022 Mar.

Abstract

Background Determining the etiology of encephalitis always remains a challenge to clinicians, and also, variables that predict outcome in acute phase settings are not known precisely. The autoimmune causes of acute encephalitis are increasing due to the availability of newer diagnostic markers, whereas earlier studies were primarily focused on infectious causes. We conducted a prospective study to determine the demographic profile, etiological aspect, and in-hospital outcome of patients admitted with acute encephalitis syndrome (AES) in our tertiary care center. Materials and method This observational prospective study was carried out at a tertiary care hospital between November 2016 and October 2018. With a sample size of 72, appropriate statistical analysis was done. Results The incidence of AES usually escalates during the rainy season, with arboviral etiologies being predominant. The majority of the patients with AES with a likely infectious etiology could not be diagnosed with presently available viral marker studies. Among various clinical variables, a low Glasgow Coma Scale (GCS) score on admission, a high CSF protein value, and diffusion restriction on brain MRI was associated with poor outcome. Conclusion Acute encephalitis and encephalitis-related mortality impose a considerable burden on current medical practice. The reported demographics of hospitalized patients with encephalitis may be changing, which are important factors to consider for etiological workup.

摘要

背景 确定脑炎的病因一直是临床医生面临的挑战,而且,急性期预测预后的变量也尚未完全明确。由于有了更新的诊断标志物,急性脑炎的自身免疫性病因正在增加,而早期研究主要集中在感染性病因上。我们进行了一项前瞻性研究,以确定在我们的三级医疗中心收治的急性脑炎综合征(AES)患者的人口统计学特征、病因及住院结局。材料与方法 这项观察性前瞻性研究于2016年11月至2018年10月在一家三级医疗医院进行。样本量为72例,并进行了适当的统计分析。结果 AES的发病率通常在雨季上升,虫媒病毒病因占主导。大多数可能有感染性病因的AES患者无法通过目前可用的病毒标志物研究确诊。在各种临床变量中,入院时格拉斯哥昏迷量表(GCS)评分低、脑脊液蛋白值高以及脑MRI上的弥散受限与预后不良相关。结论 急性脑炎和与脑炎相关的死亡率给当前医疗实践带来了相当大的负担。所报道的住院脑炎患者的人口统计学特征可能正在发生变化,这是病因检查中需要考虑的重要因素。

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