Abstract
Background
Children who present with seizure and/or impaired consciousness accompanied by fever
without known etiology (SICF) may be diagnosed with either acute encephalopathy (AE)
or febrile seizure (FS). Although approximately 5% of AE cases are fatal, it is difficult
to identify fatal cases among children with SICF, which are often critical by the
time of diagnosis. Thus, early prediction of outcomes for children with SICF, prior
to diagnosis, may help to reduce mortality associated with AE. The aim of the present
study was to identify clinical and laboratory risk factors for mortality acquired
within 6 h of onset among children with SICF.
Methods
We retrospectively reviewed the medical records of children who had been admitted
to Kobe Children’s Hospital (Kobe, Japan) with SICF between October 2002 and September
2015. We compared clinical and laboratory characteristics acquired within 6 h of onset
and outcomes between survivors and non-survivors using univariate and multivariate
analyses.
Results
The survivor and non-survivor groups included 659 and nine patients, respectively.
All patients in the non-survivor group received a final diagnosis of AE. Univariate
analysis revealed significant differences between the groups with regard to seizure
duration and the following laboratory parameters: aspartate transaminase (AST), alanine
aminotransferase, lactate dehydrogenase, sodium, and lactate. The multivariate analysis
identified AST as a significant independent factor associated with mortality.
Conclusions
Elevation of AST within 6 h of onset is independently correlated with mortality in
children with SICF. Our result may elucidate earlier intervention for patients with
high risk of mortality.
Keywords
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Article info
Publication history
Published online: March 19, 2018
Accepted:
February 28,
2018
Received in revised form:
February 27,
2018
Received:
November 27,
2017
Identification
Copyright
© 2018 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.
