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Pediatric Patients With Acute Flaccid Myelitis: Long-term Respiratory and Neurologic Outcomes
Dimple Patel1,2,3, Emily A Kragel4, Shih-Dun Liu4
1From the Pediatric Hospital Medicine Fellowship, Kaiser Permanente Oakland Medical Center, Oakland, CA.
The Pediatric Infectious Disease Journal
|December 10, 2024
Summary
Pediatric acute flaccid myelitis (AFM) patients with respiratory failure at presentation face worse outcomes. These include needing long-term respiratory support and experiencing prolonged neurologic deficits.
Area of Science:
- Neurology
- Infectious Diseases
- Pediatrics
Background:
- Acute flaccid myelitis (AFM) is a neurologic condition often linked to infections.
- AFM can lead to respiratory failure and variable recovery.
- Understanding long-term outcomes based on initial respiratory status is crucial.
Purpose of the Study:
- To assess long-term respiratory and neurologic outcomes in pediatric AFM patients.
- To provide data on outcomes stratified by respiratory status at presentation.
- To contribute to the limited literature on pediatric AFM.
Main Methods:
- Retrospective cohort study utilizing a large healthcare database.
- Identified pediatric patients (1-18 years) diagnosed with AFM (2011-2019).
- Compared outcomes between patients with and without respiratory failure during hospitalization.
Main Results:
- Overall AFM incidence was 0.6 per 100,000 person-years.
- 21.6% of AFM patients experienced respiratory failure.
- Respiratory failure was associated with higher Modified Rankin Scores and increased healthcare utilization.
Conclusions:
- Respiratory failure at AFM presentation predicts worse outcomes.
- Patients with respiratory failure require more respiratory support and have prolonged deficits.
- Findings highlight the impact of initial respiratory status on pediatric AFM prognosis.
