Clinico-epidemiological characteristics of hospitalized acute encephalitis syndrome children and their correlation with case fatality rate

Kakoti, Gitali; Das, Bishnu Ram

doi:10.4103/jfmpc.jfmpc_1645_20

J Family Med Prim Care

2020

DOI: 10.4103/jfmpc.jfmpc_1645_20

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Clinico-epidemiological characteristics of hospitalized acute encephalitis syndrome children and their correlation with case fatality rate

Gitali Kakoti¹,

Bishnu Ram Das²

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Cited by 2 publications

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“…Physicians should closely monitor factors such as the need for assisted ventilation, advanced age, and a Glasgow Coma Scale score below 8 at presentation. Similar studies by Kakoti et al have indicated that children with GCS equal to or less than 8 and the presence of meningeal irritation had significantly higher fatality rates[9,10]].…”

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confidence: 53%

The Clinical Profile and Prognostic Factors Influencing Mortality in Patients With Acute Encephalitis Syndrome

Tiwari,

Ingle,

Goyal

2023

Cureus

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Introduction Acute encephalitis syndrome (AES) is a significant global public health concern. AES is a disorder characterized by fever and altered mental status, and it is associated with considerable morbidity and mortality. There is a limited amount of existing literature on the clinical profile and prognostic markers that influence mortality in these patients. Our study seeks to comprehend the etiology, clinical characteristics, complications, and prognostic markers that impact mortality among patients with AES. Methods The study was a prospective observational study conducted over 18 months, involving a sample size of 105 patients. Patients aged 12 years and older, who met the WHO case definition of Acute Encephalitis Syndrome (AES), were consecutively recruited for this study. The patients' details were recorded, including their medical history and physical and clinical examination findings upon admission. The extent of cognitive impairment was evaluated using the Glasgow Coma Scale (GCS). Additionally, the patient's presenting symptoms, any complications experienced during their hospital stay, and the mortality rate were documented. The etiology, MRI results of the brain, laboratory parameters, and the need for assisted ventilation were also recorded. In-hospital characteristics were analyzed using the t-test for continuous variables and the chi-square test for binary variables. The log-rank test was employed to identify the predictors with the most significant independent influence on prognosis. All participants were selected only after obtaining their written informed consent. Results Most of the patients were in the age group of 21-30. 60% of the patients were male. Advanced age at presentation was associated with an increased risk of mortality (p-value=0.018). All patients presented to the hospital with symptoms of fever and altered sensorium. The most common agent isolated as the etiologic cause was HSV-1 , found in 31.4% of the patients. 28.6% of the patients succumbed to death. The leading cause of death was raised intracranial pressure leading to hemorrhage in the brain. There was no significant correlation between the duration of symptoms and the primary outcome of death (p-value=0.498). The requirement for assisted ventilation was shown to increase the risk of death (p-value=0.001). A low GCS score at presentation was associated with a higher mortality rate (p-value=0.048). Conclusions The factors that predict mortality in AES involve a complex interplay of patient demographics, viral etiology, clinical severity, neuroimaging findings, and the need for assisted ventilation. Integrating these factors into clinical practice would enable healthcare providers to make informed decisions regarding patient management and interventions. As our comprehension of AES continues to develop, forthcoming advancements in diagnostics and therapeutics could refine prognostic assessments further. These developme...

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confidence: 53%

The Clinical Profile and Prognostic Factors Influencing Mortality in Patients With Acute Encephalitis Syndrome

Tiwari,

Ingle,

Goyal

2023

Cureus

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Acute Encephalitis Syndrome in Children and Adolescents: A Five-Year Descriptive Study From South India

Rebecca,

Thomas,

Abraham

et al. 2024

Indian Pediatr

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Clinico-epidemiological characteristics of hospitalized acute encephalitis syndrome children and their correlation with case fatality rate

Cited by 2 publications

References 17 publications

The Clinical Profile and Prognostic Factors Influencing Mortality in Patients With Acute Encephalitis Syndrome

The Clinical Profile and Prognostic Factors Influencing Mortality in Patients With Acute Encephalitis Syndrome

Acute Encephalitis Syndrome in Children and Adolescents: A Five-Year Descriptive Study From South India

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