Prognostic indicators of childhood acute viral encephalitis.

  • 1 December 1999
    • journal article
    • Vol. 49  (12) , 311-6
Abstract
To devise a set of clinical signs and laboratory parameters that would help clinicians assess prognosis in patients and plan appropriate management. Medical records of 147 paediatric cases (with a discharge diagnosis of acute viral encephalitis) admitted over a ten year period from 1987 to 1997 were reviewed and relevant information collected on a data extraction form. Of 147 patients, 24 (16.3%) died and 48 (32.7%) were left with severe neurological deficits. A GCS (Glasgow Coma Scale) score between 6-10 had an association with poor outcome (OR = 2.62, Chi-square = 5.57, p-value = 0.018) and that a GCS score of > or = 5 was even more strongly suggestive of poor outcome (OR = 5.49, Chi-square = 12.08, p-value = 0.0005). A history of having seizures, for more than 3 days, also showed a strong association with poor outcome (OR = 3.66, Chi-square = 5.46, p-value = 0.019). Patients with an increased risk of death and severe disability can be identified using a few guidelines. Of these, a history of seizures of > 3 days and/or impaired consciousness (GCS < or = 10), at the time of presentation to the hospital, constitute high risk. These cases must be identified promptly and aggressive therapy initiated in order to improve long term outcome.

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