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Acute febrile encephalopathy in children and predictors of mortality

Cm Bokade1, Rr Gulhane2, As Bagul3

  • 1Professor, Department of Pediatrics, Government Medical College , Nagpur, Maharashtra, India .

Journal of Clinical and Diagnostic Research : JCDR
|October 11, 2014
PubMed

Insights

Predictors of mortality in acute febrile encephalopathy (AFE) in children include shock, severe anemia, bradycardia, low Glasgow Coma Scale (GCS), and refractory seizures. Identifying these factors aids in managing AFE and improving outcomes.

Area of Science:

  • Pediatric Neurology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Acute febrile encephalopathy (AFE) presents a significant health challenge in children, characterized by high mortality and long-term sequelae.
  • Data on mortality predictors for AFE in children from central India is limited.

Purpose of the Study:

  • To identify independent predictors of mortality in pediatric patients diagnosed with acute febrile encephalopathy.
  • To inform clinical management strategies and improve survival rates for children with AFE.

Main Methods:

  • An observational, prospective study was conducted over two years in a tertiary care hospital in central India.
  • 176 children (1 month to 12 years) with fever and altered mental status were enrolled.
  • Statistical analysis included Chi-square, Fisher's exact test, and multivariate regression (P≤0.05).

Main Results:

  • Viral encephalitis was the most common diagnosis (46.59%), followed by pyogenic meningitis, tuberculous meningitis, and cerebral malaria.
  • Independent predictors of mortality identified were shock, severe anemia, bradycardia, Glasgow Coma Scale (GCS) < 8, and refractory seizures.
  • Respiratory failure, multiorgan dysfunction syndrome, and abnormal coagulation were not significant predictors in the multivariate model.

Conclusions:

  • Refractory seizures, GCS < 8, bradycardia, shock, and severe anemia are significant independent predictors of mortality in pediatric AFE.
  • Early identification and management of these factors are crucial for improving patient outcomes.
Abstract

Keywords:
Acute febrile encephalopathy (AFE)ChildrenMortalityPredictors

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