Multivariate Analysis Of Prognosis Of Severe Viral Encephalitis In Children In Southern Henan Province

1 Background and purposeSevere viral encephalitis(SVE)is a serious disease for children.Not only is the mortality and disability rate high,it also threatens the survival and quality of their lives.The pathogen is diverse,the clinical manifestation is changeable,the etiological diagnosis is insufficient,and the prognosis is poor.At the same time,there were certain differences in the epidemiological characteristics of SVE and risk assessment of prognosis,due to different regions,research methods or objects of study.Therefore,it is necessary to count and analyze the clinical data of children with SVE in specific areas.Xinyang is located in the south of Henan Province---China geographical boundaries(Qinling Mountains-Huaihe River),and it is between subtropical zone and warm temperate zone,with Huaihe riverbed bounded.The geographical location and climate here is unique,with the south subtropical humid monsoon climate,and the north temperate monsoon semi humid climate.There may be regional characteristics in the etiology and epidemiology of viral encephalitis.Statistics and analysis of the clinical data of SVE patients this area not only contribute to improving the epidemiological data of SVE children in Xinyang and the surrounding region,but also contribute to early warning and experiential therapy of regional children with SVE.The pediatric intensive care unit of Xinyang Central Hospital is the only care unit which undertakes treatment to children with SVE in Xinyang and the surrounding region.Therefore,the factors which affect the prognosis of children with SVE in our hospital were discussed,and the reference index for predicting the prognosis of children with SVE was obtained to guide the clinical evaluation of the disease and the diagnosis and treatment.At the same time,it provides a useful reference for the epidemic characteristics of SVE in children in Xinyang and the surrounding region.2 MethodsThe clinical data,auxiliary examination results and laboratory test results was collected from 54 SVE patients from December 2014 to November 2016 in Xinyang Central Hospital pediatric intensive care unit to analyze the epidemiological characteristics of cases,and the Glasgow outcome scale(GOS)was used in patients at discharge to evaluate the prognosis and the degree of disability.By statistically analyzing the data through cohort review analysis method,observing many possible correlation factors and performing the prognosis of multiple Logistic regression analysis,the independent dangerous factors affecting prognosis were obtained.At the same time,the epidemiological data of SVE in children in Xinyang and the surrounding region was analyzed to explore the epidemiological characteristics of SVE in this region.3 Results35(64.8%)SVE cases of children occurred from July to September,and the incidence of SVE were related to the monthly average temperature and monthly precipitation,but not completely parallel.88.9% SVE cases of children morbidity was concentrated in townships or towns.In the count data,the Glasgow Coma Scale(GCS)score,the need for mechanical ventilation,injury of cranial nerve and MRI abnormalities in the two groups were statistically significant(P<0.05).In the Measurement data,the difference of fever,peripheral white blood cell count,CRP,CK-MB,MYO and K levels in blood was statistically significant between the two groups(P<0.05).The GCS score and injury of cranial nerve were independent dangerous factors affecting prognosis.The lower the GCS score is,presence of injury of cranial nerve,the greater the possibility of poor prognosis is.4 ConclusionFrom July to September,the incidence of SVE is high in Xinyang and the surrounding region,and the incidence is higher in rural areas than in urban areas and.Epidemic type B encephalitis Virus may be an important pathogen of SVE in this region.The GCS score and injury of cranial nerve are independent dangerous factors affecting prognosis.The lower the GCS score is,presence of injury of cranial nerve,the greater the possibility of poor prognosis is.