背景:尽管大多数高热惊厥(FS)患儿预后良好,有些人在1-3年内复发。年龄,峰值温度,和家族史现在被认为是FS复发的重要危险因素,然而,中国缺乏这方面的研究。本研究旨在探讨南通市儿童FS复发的危险因素。中国,并建立预测模型。
方法:这项回顾性队列研究分析了2015年1月至2020年6月在南通大学附属医院就诊的463例高热惊厥(FS)患儿。基本信息,疾病特征,收集实验室和影像学数据。出院后一年进行跟踪调查,以评估儿童FS的复发状况。采用单因素logistic回归和随机森林模型对复发危险因素的预测能力进行识别和排序。
结果:在463名FS儿童中,出院后1年内有70例复发,导致一年复发率为15%。年龄(OR=0.61,95%CI:0.46,0.80,P<0.001),首次发作持续时间(OR=1.03,95%CI:1.00,1.06,P=0.040),和峰值温度(OR=0.68,95%CI:0.47,0.98,P=0.036)被确定为FS复发的独立危险因素。年龄在预测FS复发中具有最高的相对重要性,接下来是第一集的持续时间,ROC曲线下面积为0.717。
结论:年龄小和首次发作持续时间是FS复发的重要独立危险因素,也是预测复发的关键因素。需要进一步的研究来确认中性粒细胞-淋巴细胞比率(NLR)作为FS复发的预测因子的潜在用途。
BACKGROUND: Although most children with febrile seizures (FS) have a favorable prognosis, some experience recurrence within 1-3 years. Age, peak temperature, and family history are now recognized as important risk factors for FS recurrence, yet studies in this area are lacking in China. This study aimed to investigate the risk factors for FS recurrence in children in Nantong, China, and to develop a prediction model.
METHODS: This retrospective cohort study analyzed 463 children diagnosed with febrile seizures (FS) who presented to the Affiliated Hospital of Nantong University between January 2015 and June 2020. Basic information, disease characteristics, and laboratory and imaging data were collected. A follow-up survey was conducted one year post-discharge to assess the recurrence status of FS in children. Univariate logistic regression and random forest models were used to identify and rank the predictive ability of risk factors for recurrence.
RESULTS: Of the 463 children with FS, 70 experienced recurrences within 1 year of discharge, resulting in a one-year recurrence rate of 15%. Age (OR = 0.61, 95% CI: 0.46, 0.80, P < 0.001), duration of the first episode (OR = 1.03, 95% CI: 1.00, 1.06, P = 0.040), and peak temperature (OR = 0.68, 95% CI: 0.47, 0.98, P = 0.036) were identified as independent risk factors for FS recurrence. Age had the highest relative importance in predicting FS recurrence, followed by the duration of the first episode, with an area under the ROC curve of 0.717.
CONCLUSIONS: Young age and duration of the first seizure are important independent risk factors for FS recurrence and are key considerations for predicting recurrence. Further research is needed to confirm the potential use of Neutrophil-lymphocyte ratio (NLR) as a predictor of FS recurrence.