title: [Risk factors for death in children with severe hand, foot and mouth disease].
abstract: OBJECTIVE
  To study the death risk factors in children with severe hand, foot and mouth disease (HFMD).
  
  
  METHODS
  A total of 164 children with severe HFMD between May 2010 and September 2012 were recruited and classified into death and survival groups according to their prognosis. The differences in general information, clinical signs and symptoms and laboratory examinations were compared between the two groups. The multivariate logistic regression analysis was used to identify death risk factors in children with severe HFMD.
  
  
  RESULTS
  There were significant differences in the incidences of atypical rash, persistent fever, dyspnea, pulmonary hemorrhage, heart rate increase, blood pressure abnormalities, cold sweat, capillary refill time>3 seconds and frequent seizures, and blood glucose, serum creatine kinase and serum lactate levels between the death and the survival groups (P&lt;0.05). The multivariate logistic regression analysis showed three independent death risk factors for children with severe HFMD: pulmonary hemorrhage (OR=9.466, 95%CI: 1.786-21.256), abnormal blood pressure (OR=5.224, 95%CI: 1.012-28.985) and elevated serum lactate level (OR=2.154, 95%CI: 1.020-8.253).
  
  
  CONCLUSIONS
  Pulmonary hemorrhage, abnormal blood pressure and elevated serum lactate are major death risk factors for children with severe HFMD.
authors.affiliation: Department of Intensive Care Unit II, Zhengzhou Children&prime;s Hospital, Zhengzhou 450003, China. 13703829317@163.com.
authors.forename: Chun-Lan
authors.initials: CL
authors.lastname: Song
authors.forename: Yi-Bing
authors.initials: YB
authors.lastname: Cheng
authors.forename: Dan
authors.initials: D
authors.lastname: Chen
authors.forename: Xue
authors.initials: X
authors.lastname: Gu
authors.forename: Hai-Bei
authors.initials: HB
authors.lastname: Li
authors.forename: Xiao-Qing
authors.initials: XQ
authors.lastname: Yan
mesh_terms: D001794:Blood Pressure; D002648:Child; D002675:Child, Preschool; D005260:Female; D006232:Hand, Foot and Mouth Disease / Q000097:blood / Q000401:mortality* / Q000503:physiopathology; D006801:Humans; D007223:Infant; D019344:Lactic Acid / Q000097:blood; D016015:Logistic Models; D008297:Male; D011379:Prognosis; D012307:Risk Factors
chemical_list: D019344:Lactic Acid