Prognostic indicators of childhood acute viral encephalitis.
OBJECTIVE
To devise a set of clinical signs and laboratory parameters that would help clinicians assess prognosis in patients and plan appropriate management.


METHODS
Medical records of 147 paediatric cases (with a discharge diagnosis of acute viral encephalitis) admitted over a ten year period from 1987 to 1997 were reviewed and relevant information collected on a data extraction form.


RESULTS
Of 147 patients, 24 (16.3%) died and 48 (32.7%) were left with severe neurological deficits. A GCS (Glasgow Coma Scale) score between 6-10 had an association with poor outcome (OR = 2.62, Chi-square = 5.57, p-value = 0.018) and that a GCS score of > or = 5 was even more strongly suggestive of poor outcome (OR = 5.49, Chi-square = 12.08, p-value = 0.0005). A history of having seizures, for more than 3 days, also showed a strong association with poor outcome (OR = 3.66, Chi-square = 5.46, p-value = 0.019).


CONCLUSIONS
Patients with an increased risk of death and severe disability can be identified using a few guidelines. Of these, a history of seizures of > 3 days and/or impaired consciousness (GCS < or = 10), at the time of presentation to the hospital, constitute high risk. These cases must be identified promptly and aggressive therapy initiated in order to improve long term outcome.
Bhutto
E
E
Department of Community Health Sciences, Aga Khan University, Karachi.
Naim
M
M
Ehtesham
M
M
Rehman
M
M
Siddique
M A
MA
Jehan
I
I
D000208:Acute Disease; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D018792:Encephalitis, Viral / Q000175:diagnosis / Q000401:mortality; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D007223:Infant; D008297:Male; D010154:Pakistan / Q000453:epidemiology; D011379:Prognosis; D016019:Survival Analysis