Analysis Of Prognostic Factors In Adult Japanese Encephalitis

Objective:The clinical data of adult patients with Japanese encephalitis admitted to the Second Hospital of Lanzhou University in Gansu Province were collected to explore the factors related to the short-term prognosis of patients with adult Japanese encephalitis,and to provide evidence for early intervention.Methods:A retrospective analysis of 85 patients with Japanese encephalitis admitted to the Second Hospital of Lanzhou University in Gansu Province from June2017 to December 2018,and collected clinical data of 85 patients.The patients were followed up by telephone at 3 months after onset,and the prognosis was evaluated by Liverpool Outcome Score(LOS)(LOS score?2 was classified into poor prognosis group,LOS score>2 was classified into good prognosis group).The data were processed by SPSS22.0 statistical software to analyze the factors affecting the prognosis of acute Japanese encephalitis.Result:The study included 85 patients.At 3 months of follow-up,35(41.2%)patients had a poor prognosis,of which 11(12.9%)died.All patients had different degrees of disturbance of consciousness.Among them,23(27%)patients had moderate-deep coma,19 cases had poor prognosis and 4 cases had good prognosis(P<0.001).There were 43(50.6%)patients with epilepsy,of which 24 cases had poor prognosis and 19 cases had good prognosis(P=0.006);19 patients had status epilepticus,of which 12 cases had poor prognosis and 7 cases had good prognosis(P=0.027).There were 25(29.4%)patients with central respiratory failure,of which18 cases had poor prognosis and 7 cases had good prognosis(P<0.001).There were31(36.5%)patients with dystonia,of which 19 cases had poor prognosis and 12 cases had good prognosis(P=0.004).47(55.3%)patients had abnormal initial pressure of cerebrospinal fluid.The median of poor prognosis group was 210 mmH2O,and that of good prognosis group was 170 mmH2O(P=0.007).WBC in cerebrospinal fluid was abnormal in both groups.The median of poor prognosis group was 106x10~6/L,while that of good prognosis group was 64.5x10~6/L(P=0.024).There were 64(75.3%)patients with abnormal protein content in cerebrospinal fluid.The median of poor prognosis group was 1.05g/L,and that of good prognosis group was 0.67g/L(P<0.001).There were 56(65.9%)patients with positive meningeal stimulation sign,29 of them had poor prognosis and 27 had good prognosis(P=0.006).There were 61(71.8%)patients with abnormal cranial MRI,30 cases with poor prognosis,31 cases with good prognosis(P=0.017).38(44.7%)patients with abnormal bilateral thalamic signal,21 cases with poor prognosis and 17 cases with good prognosis(P=0.018).Univariate analysis showed that there were significant differences between the groups with good prognosis and those with poor prognosis in the following aspects:Degree of level of consciousness disorder,epilepsy,status epilepticus,central respiratory failure,dystonia,initial pressure of cerebrospinal fluid,WBC of cerebrospinal fluid,protein content of cerebrospinal fluid,positive meningeal stimulation sign,abnormal brain MRI and bilateral thalamic signal.Multivariate logistic regression analysis showed that moderate-deep coma,central respiratory failure and cerebrospinal fluid protein content were risk factors for poor prognosis of Japanese encephalitis in adults patients at 3 months.Conclusion:Moderate-deep coma,central respiratory failure,and cerebrospinal fluid protein content are factors affecting the 3-month prognosis of adult patients with Japanese encephalitis.