Clinical characteristics and short-term outcomes of Japanese encephalitis in pediatric and adult patients: a retrospective study in Northern China.
Clinical characteristics and short-term outcomes of Japanese encephalitis in pediatric and adult patients: a retrospective study in Northern China.
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DOI：
10.3389/fneur.2023.1135001
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发表时间：
2023
影响因子：
3.4
通讯作者：
Guo, Shougang
中科院分区：
文献类型：
--
作者：
Zhang, Fangyuan;Xu, Guangyin;Zhang, Xiaoyu;Li, Yue;Li, Dong;Wang, Chunjuan;Guo, Shougang
本研究旨在比较儿童和成人乙型脑炎（JE）患者的临床特征和短期结局，以找出差异。从2006年8月至2019年10月，入组了107例JE患者（62例儿童患者和45例成人患者）。分析其临床特点及近期疗效。根据患者出院时的格拉斯哥昏迷量表（GCS）评分（GCS > 8 vs. GCS ≤ 8），将患者的短期结局定义为良好结局或不良结局。至于急性并发症，25例成人（25/45，55.6%）肺部感染的发生率高于19例儿童（19/62，30.6%; P = 0.01）。上消化道出血在肺部感染患者中更常见，其中10例患者出现症状（10/44，22.7%），而只有1例患者没有肺部感染（1/63，1.6%; P = 0.001）。合并肺部感染的患者机械通气和进入重症监护室（ICU）接受支持治疗的比例高于无感染的患者（分别为P < 0.001，P = 0.008）。有肺部感染者出院时GCS评分（7，4 ~ 12.75）低于无肺部感染者（14，10-14; P < 0.001）。儿童入院时GCS评分（9.5，7-13分）与成人（7，6-13分）相似，但成人出院时GCS评分（7，3.5 ~ 13分）低于儿童（13，10.75 ~ 14分; P < 0.001）。成人乙脑的短期预后更差。肺部感染与乙脑患者上消化道出血、机械通气和ICU住院的高发生率相关。肺部感染是乙脑患者短期预后的预测因子。应开始为成人接种疫苗。
The study aimed to compare the clinical characteristics and short-term outcomes of pediatric and adult Japanese encephalitis (JE) patients in order to find out the differences. From August 2006 to October 2019, 107 patients (62 pediatric patients and 45 adult patients) with JE were enrolled. Clinical characteristics and short-term outcomes were analyzed. The short-term outcome of each patient was defined as a good outcome or poor outcome according to their Glasgow Coma Scale (GCS) scores (GCS > 8 vs. GCS ≤ 8) at discharge. As for acute complications, the incidence of pulmonary infection was higher in 25 adults (25/45, 55.6%) than in 19 children (19/62, 30.6%; P = 0.01). Upper gastrointestinal bleeding was more common in patients with pulmonary infection, with 10 of these patients experiencing the symptom (10/44, 22.7%) compared to only one patient without pulmonary infection (1/63, 1.6%; P = 0.001). The proportion of mechanical ventilation and admission to the intensive care unit (ICU) for supportive care was higher in patients with pulmonary infection than in patients without infection (P < 0.001, P = 0.008, respectively). The GCS scores at discharge in patients with pulmonary infection (7, 4–12.75) were lower than in patients without pulmonary infection (14, 10-14; P < 0.001). Although the GCS scores at the admission of children (9.5, 7–13) were similar to that of adults (7, 6–13), the GCS scores at the discharge of adults (7, 3.5–13) were lower than that of children (13, 10.75–14; P < 0.001). The short-term outcome of JE was worse in adults. Pulmonary infection was correlated with a high incidence of upper gastrointestinal bleeding, mechanical ventilation, and ICU hospitalization in JE. Pulmonary infection is a prognostic predictor of short-term outcomes in patients with JE. Vaccination for adults should be initiated.
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