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Abstract：
Influenza-Associated Encephalopathy/Encephalitis (IAE) is characterized by high incidence and poor prognosis. The aim of this study is to describe the clinical features and outcomes of IAE in pediatric patients.
We performed a retrospective review of hospitalized cases of laboratory-confirmed influenza infection between January 2018 and December 2021. Demographic, clinical, imaging, treatment and outcome data were collected. Statistical analysis was performed using SPSS software.
Of 446 children hospitalized with influenza, 71 cases were identified with a diagnosis of IAE. The median age was 3 years and 46 (64.8 %) were younger than 5 years. Only one patient was vaccinated for seasonal influenza. 46 (64.8 %) patients had abnormal electroencephalogram examination and 47 (66.2 %) had abnormal brain MRI or CT findings. 68 (95.8 %) patients were treated with oseltamivir/peramivir. 12 (16.9 %) patients suffered mortality. Non-survivors were more likely to have lower Glasgow coma score (median 7), longer duration of fever (median 3 days), with underlying medical conditions (P = 0.006), and complications including sepsis (P = 0.003), shock (P < 0.001), respiratory failure (P = 0.006), acute renal failure (P = 0.001), myocardial damage (P < 0.001), coagulation disorders (P = 0.03), electrolyte disturbance (P = 0.001) and hyperlactacidemia (P = 0.003). Non-survivors had higher percentages of corticosteroids (P = 0.003) and immunoglobulin (P = 0.003) treatments compared to survivors.
Children with IAE have a high mortality rate. Lower Glasgow coma score, longer duration of fever, with underlying medical conditions and complications pose a great risk to poor prognosis. Influenza vaccination is recommended to all eligible children.
We performed a retrospective review of hospitalized cases of laboratory-confirmed influenza infection between January 2018 and December 2021. Demographic, clinical, imaging, treatment and outcome data were collected. Statistical analysis was performed using SPSS software.
Of 446 children hospitalized with influenza, 71 cases were identified with a diagnosis of IAE. The median age was 3 years and 46 (64.8 %) were younger than 5 years. Only one patient was vaccinated for seasonal influenza. 46 (64.8 %) patients had abnormal electroencephalogram examination and 47 (66.2 %) had abnormal brain MRI or CT findings. 68 (95.8 %) patients were treated with oseltamivir/peramivir. 12 (16.9 %) patients suffered mortality. Non-survivors were more likely to have lower Glasgow coma score (median 7), longer duration of fever (median 3 days), with underlying medical conditions (P = 0.006), and complications including sepsis (P = 0.003), shock (P < 0.001), respiratory failure (P = 0.006), acute renal failure (P = 0.001), myocardial damage (P < 0.001), coagulation disorders (P = 0.03), electrolyte disturbance (P = 0.001) and hyperlactacidemia (P = 0.003). Non-survivors had higher percentages of corticosteroids (P = 0.003) and immunoglobulin (P = 0.003) treatments compared to survivors.
Children with IAE have a high mortality rate. Lower Glasgow coma score, longer duration of fever, with underlying medical conditions and complications pose a great risk to poor prognosis. Influenza vaccination is recommended to all eligible children.
摘要：
背景：流感相关性脑病/脑炎（IAE）的特征是发病率高，预后差。这项研究的目的是描述儿科患者IAE的临床特征和结果。
方法：我们对2018年1月至2021年12月期间实验室确诊的流感感染住院病例进行了回顾性分析。人口统计,临床,成像,收集治疗和结果数据.采用SPSS软件进行统计学分析。
结果：在446名因流感住院的儿童中，71例确诊为IAE。中位年龄为3岁，46岁（64.8%）小于5岁。只有一名患者接种了季节性流感疫苗。46例(64.8%)患者脑电图检查异常，47例(66.2%)患者脑MRI或CT检查异常。68例（95.8%）患者接受奥司他韦/帕拉米韦治疗。12例（16.9%）患者死亡。非幸存者更有可能有较低的格拉斯哥昏迷评分（中位数7），发热持续时间较长（中位数3天），与潜在的医疗条件（P=0.006），并发症包括脓毒症（P=0.003），休克（P<0.001），呼吸衰竭（P=0.006），急性肾功能衰竭（P=0.001），心肌损伤（P<0.001），凝血障碍（P=0.03），电解质紊乱（P=0.001）和高乳酸血症（P=0.003）。与幸存者相比，非幸存者的皮质类固醇（P=0.003）和免疫球蛋白（P=0.003）治疗百分比更高。
结论：IAE患儿死亡率高。格拉斯哥昏迷评分较低，发烧持续时间较长，潜在的医疗条件和并发症对预后不良有很大的风险。建议向所有符合条件的儿童接种流感疫苗。
方法：我们对2018年1月至2021年12月期间实验室确诊的流感感染住院病例进行了回顾性分析。人口统计,临床,成像,收集治疗和结果数据.采用SPSS软件进行统计学分析。
结果：在446名因流感住院的儿童中，71例确诊为IAE。中位年龄为3岁，46岁（64.8%）小于5岁。只有一名患者接种了季节性流感疫苗。46例(64.8%)患者脑电图检查异常，47例(66.2%)患者脑MRI或CT检查异常。68例（95.8%）患者接受奥司他韦/帕拉米韦治疗。12例（16.9%）患者死亡。非幸存者更有可能有较低的格拉斯哥昏迷评分（中位数7），发热持续时间较长（中位数3天），与潜在的医疗条件（P=0.006），并发症包括脓毒症（P=0.003），休克（P<0.001），呼吸衰竭（P=0.006），急性肾功能衰竭（P=0.001），心肌损伤（P<0.001），凝血障碍（P=0.03），电解质紊乱（P=0.001）和高乳酸血症（P=0.003）。与幸存者相比，非幸存者的皮质类固醇（P=0.003）和免疫球蛋白（P=0.003）治疗百分比更高。
结论：IAE患儿死亡率高。格拉斯哥昏迷评分较低，发烧持续时间较长，潜在的医疗条件和并发症对预后不良有很大的风险。建议向所有符合条件的儿童接种流感疫苗。
