Clinical profile and predictors of outcome in children admitted to PICU with acute encephalitis syndrome

Sambasivam, Ekambaranath; Muthaiyan, Jayakumar; Mohan, Sreedivya; Ayyavoo, Aravind Malayappan; Jayachandran, Ganesh

doi:10.18203/2349-3291.ijcp20172512

Cited by 3 publications

(4 citation statements)

References 7 publications

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“…We found hyponatraemia (Na < 130 mEq/L) was significantly associated with mortality and morbidity. Similar result was also found by Sambasivam et al (9) They showed significant mortality (23.3%) with hyponatraemia.…”

Section: Discussionsupporting

confidence: 90%

A Study on Clinical Features, Aetiology, Outcomes and Predictors of Mortality and Morbidity in Children With Acute Encephalitis Syndrome in Eastern India

Biswas¹,

Bhattacharya²,

Mondal³

et al. 2018

jemds

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BACKGROUND Acute Encephalitis Syndrome (AES) is a common condition leading to hospitalisation of children in India. Infective aetiology remains the most common cause till date. Various studies have been conducted to find out the aetiology, but very few studies on the predictors of mortality and morbidity, particularly from east India.This study was conducted to find out the causes of AES in children, clinical features, short-term outcome and predictors of morbidity and mortality. MATERIALS AND METHODSA prospective, observational study was carried out including children aged between 1 -12 yrs. with AES admitted to the Paediatric Intensive Care Unit of a tertiary care hospital in eastern India. Duration of study was one year (June 2016 -May 2017). Total 109 children were enrolled. Aetiology and outcome were evaluated. Data was analysed by SPSS version 16.0, IBM, USA. Chi-square test was applied at 5% significance level. RESULTSAmong 109 children, 11 children left against medical advice. Total 98 children were included in this study. Out of these 40 (40.8%) were below 5 yrs., 57 (58.2%) were male and 41 (41.8%) were female. Apart from fever most common presenting feature was vomiting (86.7%) followed by convulsions (84.7%) and altered sensorium (82.7%). Bacterial meningoencephalitis was the most common aetiology (45.9%) followed by viral encephalitis (29.6%) and in 24.5% cases no aetiology could be identified. Most common sequelae were seizure (28.9%) followed by weakness (11.8%) and aphasia (9.2%). Outcome was complete recovery (52%), sequelae (25.5%) and death (22.5%). Low GCS < 8, shock and patient requiring mechanical ventilation were associated with poor outcome. CONCLUSIONBacterial meningoencephalitis and viral encephalitis are common causes of AES. Low GCS, shock and mechanical ventilation were independent predictors for mortality in children. KEY WORDSAES, Outcome, Mortality, Sequelae. HOW TO CITE THIS ARTICLE: Biswas R, Bhattacharya T, Mondal T, et al. A study on clinical features, aetiology, outcomes and predictors of mortality and morbidity in children with acute encephalitis syndrome in eastern India.

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Section: Discussionsupporting

confidence: 90%

A Study on Clinical Features, Aetiology, Outcomes and Predictors of Mortality and Morbidity in Children With Acute Encephalitis Syndrome in Eastern India

Biswas¹,

Bhattacharya²,

Mondal³

et al. 2018

jemds

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“…In this study, the mortality rate of patients with intracranial infections in children at our tertiary referral hospital was 25%. This mortality rate is smaller than the mortality rate from acute encephalopathy reported in India (36.67%) [ 5 ] and the mortality rate from bacterial meningitis reported in Mexico in 2003 (33%) [ 12 ]. The mortality rate in our study was not much different from a previous study in the same setting, Dr. Sardjito General Hospital in 2014 which amounted to 22.1% [ 13 ].…”

Section: Discussionmentioning

confidence: 66%

“…Several studies have been done specifically related to intracranial infection, encephalitis, meningitis, brain abscess or other intracranial infections. Research on factors associated with mortality in encephalitis has been done before and one study stated that the factors influencing mortality in pediatric patients with acute encephalitis who were admitted to the pediatric intensive care unit (PICU) were hyponatremia and patients who were in shock and received inotropes on admission [ 5 ]. Research conducted in adult patient subjects found that death in encephalitis was associated with cerebral edema, epileptic state and thrombocytopenia [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Factors associated with mortality in intracranial infection patients admitted to pediatric intensive care unit: A retrospective cohort study

Kholifia¹,

Rusmawatiningtyas²,

Makrufardi³

et al. 2021

Annals of Medicine and Surgery

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Background Intracranial infection is a major cause of emergency and death in children. To assist clinical decision-making in patient management, we conducted a study about factors associated with mortality. This study aimed to evaluate factors associated with mortality in pediatric patients with intracranial infection. Methods We performed a cohort retrospective study in our tertiary hospital to evaluate the outcomes of patients admitted to the pediatric intensive care unit (PICU) from 2014 to 2018. The Chi-square test was performed to determine the significance of the predictor, and p < 0.05 was considered to indicate a statistically significant result. We used multivariate logistic regression to determine relative risk (RR) with 95% confidence interval (CI). Results We recruited 112 patients who were admitted to the PICU of our tertiary hospital. A total of 38.4% were diagnosed with encephalitis, 9.8% meningitis and 51.8% meningoencephalitis. Of the 112 patients who met the inclusion criteria, 28 (25%) patients died in the PICU. The need of mechanical ventilation support variable had a statistically significant association with mortality (RR 22 . 76; 95% CI: 3 . 88–51.45). Conclusion Recognition of conditions that exacerbate intracranial infection in children needs to be done as early as possible. Moreover, the need of mechanical ventilation support in the PICU needs more attention.

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“…7,8 The least number of cases that is, in the age group of 1month to less than 1 year constituted 9.26% of the total cases. This finding closely resembles the finding of Kakoti et al (2.98%) 5.…”

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confidence: 98%

A study of the outcome of acute encephalitis syndrome in children

Barbhuiyan

Bezboruah

2021

Int J Contemp Pediatr

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Background: Acute encephalitis syndrome (AES) is defined as a person of any age, at any time of the year, with acute onset of fever and a change in mental status (including symptoms such as confusion, disorientation, coma, inability to talk) and/or new onset of seizures (excluding simple febrile seizures) [WHO]. Japanese encephalitis (JE) is one of the leading causes of AES affecting children and adolescents in the tropical countries. Objective of the study were to study the outcome of children with AES. The study was conducted in the department of pediatrics, Gauhati medical college and hospital, Guwahati from 1st July 2016 to 30th June 2017.Methods: Patients admitted in the pediatrics department of Gauhati medical college and hospital, Guwahati with diagnosis of AES during the study period were taken into account based on inclusion and exclusion criteria.Results: It has been observed that age, awareness among caregivers, poor GCS, multiple seizures, shock are important factors in the outcome of AES.Conclusions: From the present study, prognosis of the cases may be predicted and measures taken to improve outcome

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Clinical profile and predictors of outcome in children admitted to PICU with acute encephalitis syndrome

Cited by 3 publications

References 7 publications

A Study on Clinical Features, Aetiology, Outcomes and Predictors of Mortality and Morbidity in Children With Acute Encephalitis Syndrome in Eastern India

A Study on Clinical Features, Aetiology, Outcomes and Predictors of Mortality and Morbidity in Children With Acute Encephalitis Syndrome in Eastern India

Factors associated with mortality in intracranial infection patients admitted to pediatric intensive care unit: A retrospective cohort study

A study of the outcome of acute encephalitis syndrome in children

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