title: Neurological complications and risk factors of cardiopulmonary failure of EV-A71-related hand, foot and mouth disease.
abstract: From 2010 to 2012, large outbreaks of EV-A71-related- hand foot and mouth disease (HFMD) occurred annually in China. Some cases had neurological complications and were closely associated with fatal cardiopulmonary collapse, but not all children with central nervous system (CNS) involvement demonstrated a poor prognosis. To identify which patients and which neurological complications are more likely to progress to cardiopulmonary failure, we retrospectively studied 1,125 paediatric inpatients diagnosed with EV-A71-related HFMD in Hunan province, including 1,017 cases with CNS involvement. These patients were divided into cardiopulmonary failure (976 people) group and group without cardiopulmonary failure (149 people). A logistic regression analysis was used to compare the clinical symptoms, laboratory test results, and neurological complications between these two groups. The most significant risk factors included young age, fever duration ≥3 days, coma, limb weakness, drowsiness and ANS involvement. Patients with brainstem encephalitis and more CNS-involved regions were more likely to progress to cardiopulmonary failure. These findings can help front-line clinicians rapidly and accurately determine patient prognosis, thus rationally distributing the limited medical resources and implementing interventions as early as possible.
authors.affiliation: Department of Neurology, Xiangya Hospital, Central South University, Changsha, 410008, China.
authors.forename: Lili
authors.initials: L
authors.lastname: Long
authors.affiliation: Department of Neurology, Xiangya Hospital, Central South University, Changsha, 410008, China.|Department of Neurology, General Hospital, Tianjin Medical University, Tianjin, 300052, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Xu
authors.affiliation: Emergency center, Hunan Children's Hospital, Changsha, 410007, China.
authors.forename: Zhenghui
authors.initials: Z
authors.lastname: Xiao
authors.affiliation: Hunan Provincial Center for Disease Control and Prevention, Changsha, 410005, China.
authors.forename: Shixiong
authors.initials: S
authors.lastname: Hu
authors.affiliation: Department of Infectious disease, Hunan Children's Hospital, Changsha, 410007, China.
authors.forename: Ruping
authors.initials: R
authors.lastname: Luo
authors.affiliation: Department of Genetics, The Maternity and Child Health Hospital of Hunan Province, Changsha, 410008, China.
authors.forename: Hua
authors.initials: H
authors.lastname: Wang
authors.affiliation: Department of Intensive Care Unit, Hunan Children's Hospital, Changsha, 410007, China.
authors.forename: Xiulan
authors.initials: X
authors.lastname: Lu
authors.affiliation: Department of Intensive Care Unit, Hunan Children's Hospital, Changsha, 410007, China.
authors.forename: Zhiyue
authors.initials: Z
authors.lastname: Xu
authors.affiliation: Hunan Children's Hospital, Changsha, 410007, China.
authors.forename: Xu
authors.initials: X
authors.lastname: Yao
authors.affiliation: Department of Neurology, Xiangya Hospital, Central South University, Changsha, 410008, China.
authors.forename: Luo
authors.initials: L
authors.lastname: Zhou
authors.affiliation: Department of Neurology, Xiangya Hospital, Central South University, Changsha, 410008, China.
authors.forename: Hongyu
authors.initials: H
authors.lastname: Long
authors.affiliation: Department of Neurology, Hunan Children's Hospital, Changsha, 410007, China.
authors.forename: Jiaoe
authors.initials: J
authors.lastname: Gong
authors.affiliation: Department of Neurology, Xiangya Hospital, Central South University, Changsha, 410008, China.
authors.forename: Yanmin
authors.initials: Y
authors.lastname: Song
authors.affiliation: Medical Records Management and Information Statistics Office, Xiangya Hospital, Central South University, Changsha, 410008, China.
authors.forename: Li
authors.initials: L
authors.lastname: Zhao
authors.affiliation: Hunan Provincial Center for Disease Control and Prevention, Changsha, 410005, China.
authors.forename: Kaiwei
authors.initials: K
authors.lastname: Luo
authors.affiliation: Department of Neurology, Xiangya Hospital, Central South University, Changsha, 410008, China.
authors.forename: Mengqi
authors.initials: M
authors.lastname: Zhang
authors.affiliation: Department of Neurology, Xiangya Hospital, Central South University, Changsha, 410008, China.
authors.forename: Li
authors.initials: L
authors.lastname: Feng
authors.affiliation: Department of Neurology, Hunan Children's Hospital, Changsha, 410007, China.
authors.forename: Liming
authors.initials: L
authors.lastname: Yang
authors.affiliation: The Maternity and Child Health Hospital of Hunan Province, 410008, China.
authors.forename: Xiaoqi
authors.initials: X
authors.lastname: Sheng
authors.affiliation: Department of Infectious disease, Xiangya Hospital, Central South University, Changsha, 410008, China.
authors.forename: Xuegong
authors.initials: X
authors.lastname: Fan
authors.affiliation: Department of Neurology, Xiangya Hospital, Central South University, Changsha, 410008, China.
authors.forename: Bo
authors.initials: B
authors.lastname: Xiao
mesh_terms: D002648:Child; D002675:Child, Preschool; D004770:Enterovirus / Q000145:classification* / Q000302:isolation & purification; D005260:Female; D006232:Hand, Foot and Mouth Disease / Q000150:complications* / Q000821:virology; D006801:Humans; D008297:Male; D009422:Nervous System Diseases / Q000209:etiology*; D012307:Risk Factors