Prognostic factors in influenza-associated encephalopathy.
BACKGROUND
Recently, reports of influenza-associated encephalopathy have increased worldwide. Given the high mortality and morbidity rates attributable to this severe neurologic complication of influenza, we conducted a nationwide study in Japan to identify the prognostic factors.


METHODS
We retrospectively evaluated 442 cases of influenza-associated encephalopathy that were reported to the Collaborative Study Group on Influenza-Associated Encephalopathy, which was organized by the Japanese Ministry of Health, Labor, and Welfare in collaboration with hospitals, clinics, and local pediatric practices in Japan between 1998 and 2002. The outcome for each patient was classified as either survival or death. Predictors of death were identified using logistic regression analysis.


RESULTS
Four major prognostic factors for death were found to be significant by multivariate analysis (P < 0.05) in the 184 patients for whom we had complete data: elevation of aspartate aminotransferase, hyperglycemia, the presence of hematuria or proteinuria, and use of diclofenac sodium.


CONCLUSIONS
We identified patients who had factors associated with a poor prognosis, and these findings might be clinically useful for the management of this illness.
Nagao
Takashi
T
Department of Pediatrics, Okayama University, Graduate School of Medicine and Dentistry, Okayama, Japan.
Morishima
Tsuneo
T
Kimura
Hiroshi
H
Yokota
Syumpei
S
Yamashita
Nobuko
N
Ichiyama
Takashi
T
Kurihara
Mana
M
Miyazaki
Chiaki
C
Okabe
Nobuhiko
N
D000293:Adolescent; D001219:Aspartate Aminotransferases / Q000097:blood; D001927:Brain Diseases / Q000175:diagnosis* / Q000401:mortality / Q000821:virology*; D002648:Child; D002675:Child, Preschool; D004008:Diclofenac / Q000627:therapeutic use; D005260:Female; D006417:Hematuria; D006801:Humans; D006943:Hyperglycemia; D007223:Infant; D007231:Infant, Newborn; D007251:Influenza, Human / Q000150:complications*; D007564:Japan; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D011379:Prognosis; D011507:Proteinuria; D012189:Retrospective Studies; D012307:Risk Factors
D004008:Diclofenac; D001219:Aspartate Aminotransferases