TY - JOUR
T1 - Early risk factors for mortality in children with seizure and/or impaired consciousness accompanied by fever without known etiology
AU - Tomioka, Kazumi
AU - Nagase, Hiroaki
AU - Tanaka, Tsukasa
AU - Nishiyama, Masahiro
AU - Yamaguchi, Hiroshi
AU - Ishida, Yusuke
AU - Toyoshima, Daisaku
AU - Maruyama, Azusa
AU - Fujita, Kyoko
AU - Taniguchi-Ikeda, Mariko
AU - Nozu, Kandai
AU - Morioka, Ichiro
AU - Nishimura, Noriyuki
AU - Kurosawa, Hiroshi
AU - Uetani, Yoshiyuki
AU - Iijima, Kazumoto
N1 - Publisher Copyright:
© 2018 The Japanese Society of Child Neurology
PY - 2018/8
Y1 - 2018/8
N2 - Background: Children who present with seizure and/or impaired consciousness accompanied by fever without known etiology (SICF) may be diagnosed with either acute encephalopathy (AE) or febrile seizure (FS). Although approximately 5% of AE cases are fatal, it is difficult to identify fatal cases among children with SICF, which are often critical by the time of diagnosis. Thus, early prediction of outcomes for children with SICF, prior to diagnosis, may help to reduce mortality associated with AE. The aim of the present study was to identify clinical and laboratory risk factors for mortality acquired within 6 h of onset among children with SICF. Methods: We retrospectively reviewed the medical records of children who had been admitted to Kobe Children's Hospital (Kobe, Japan) with SICF between October 2002 and September 2015. We compared clinical and laboratory characteristics acquired within 6 h of onset and outcomes between survivors and non-survivors using univariate and multivariate analyses. Results: The survivor and non-survivor groups included 659 and nine patients, respectively. All patients in the non-survivor group received a final diagnosis of AE. Univariate analysis revealed significant differences between the groups with regard to seizure duration and the following laboratory parameters: aspartate transaminase (AST), alanine aminotransferase, lactate dehydrogenase, sodium, and lactate. The multivariate analysis identified AST as a significant independent factor associated with mortality. Conclusions: Elevation of AST within 6 h of onset is independently correlated with mortality in children with SICF. Our result may elucidate earlier intervention for patients with high risk of mortality.
AB - Background: Children who present with seizure and/or impaired consciousness accompanied by fever without known etiology (SICF) may be diagnosed with either acute encephalopathy (AE) or febrile seizure (FS). Although approximately 5% of AE cases are fatal, it is difficult to identify fatal cases among children with SICF, which are often critical by the time of diagnosis. Thus, early prediction of outcomes for children with SICF, prior to diagnosis, may help to reduce mortality associated with AE. The aim of the present study was to identify clinical and laboratory risk factors for mortality acquired within 6 h of onset among children with SICF. Methods: We retrospectively reviewed the medical records of children who had been admitted to Kobe Children's Hospital (Kobe, Japan) with SICF between October 2002 and September 2015. We compared clinical and laboratory characteristics acquired within 6 h of onset and outcomes between survivors and non-survivors using univariate and multivariate analyses. Results: The survivor and non-survivor groups included 659 and nine patients, respectively. All patients in the non-survivor group received a final diagnosis of AE. Univariate analysis revealed significant differences between the groups with regard to seizure duration and the following laboratory parameters: aspartate transaminase (AST), alanine aminotransferase, lactate dehydrogenase, sodium, and lactate. The multivariate analysis identified AST as a significant independent factor associated with mortality. Conclusions: Elevation of AST within 6 h of onset is independently correlated with mortality in children with SICF. Our result may elucidate earlier intervention for patients with high risk of mortality.
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U2 - 10.1016/j.braindev.2018.02.015
DO - 10.1016/j.braindev.2018.02.015
M3 - Article
C2 - 29567266
AN - SCOPUS:85044095316
SN - 0387-7604
VL - 40
SP - 552
EP - 557
JO - Brain and Development
JF - Brain and Development
IS - 7
ER -