医学
内科学
优势比
水肿
单变量分析
脑病
脑水肿
逻辑回归
麻醉
胃肠病学
多元分析
作者
Ichiro Kuki,Takeshi Inoue,Megumi Nukui,Shin Okazaki,Hisashi Kawawaki,Junichi Ishikawa,Kiyoko Amo,Masao Togawa,Atushi Ujiro,Hiroshi Rinka,Masashi Shiomi
标识
DOI:10.1016/j.jns.2022.120321
摘要
Abstract
Objective
Hemorrhagic shock and encephalopathy syndrome (HSES) is a severe subtype of acute encephalopathy with a poor prognosis. The factors associated with acute neurological outcomes in patients with HSES remain unclear. This study aimed to determine the clinical features, laboratory and radiological findings, and treatments that determine the acute outcomes of HSES. Methods
Forty children with HSES registered in a database of Osaka City General Hospital between 1995 and 2020 were included in this observational study. We retrospectively collected data on clinical features, laboratory and radiological items, and treatments. We divided acute neurological outcomes into two groups: the non-death and death groups in 1 week. Correlations were assessed between these items and acute neurological outcomes. Results
Twenty-seven and 13 patients comprised the non-death and death groups, respectively. Univariate logistic regression analysis showed that higher body temperature, presence of hemorrhagic episode, elevated lactate level, high glucose level in the cerebrospinal fluid, and brain edema at initial computed tomography (CT) were correlated with the death group. Regarding treatments, barbiturate therapy, intravenous immunoglobulin, and intravenous methylprednisolone were significantly initiated in the non-death group. The multivariate logistic regression model showed higher body temperature (odds ratio [OR], 4.210 [1.409–12.584]; p = 0.010) and brain edema on initial head CT (OR, 46.917 [3.995–550.976]; p = 0.002) were independent factors. Conclusions
Higher body temperature and brain edema at the onset of HSES were associated with acute outcomes. The results of this study may be useful for treatment planning and acute outcomes in patients with HSES.
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