Nationwide survey of influenza-associated acute encephalopathy in Japanese adults
| Autor: | Masaki Ishihara, Keiko Tanaka-Taya, Tsuneo Morishima, Hideo Okuno, Akihiko Morita, Kazunori Oishi, Satoshi Kamei |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male Poor prognosis medicine.medical_specialty Pediatrics Neurology Adolescent Acute encephalopathy Population Nationwide survey Young Adult 03 medical and health sciences 0302 clinical medicine Japan Influenza Human Prevalence medicine Humans Encephalitis Viral 030212 general & internal medicine education Aged Aged 80 and over education.field_of_study Adult patients business.industry Incidence Middle Aged Prognosis Health Surveys Methylprednisolone Female Neurology (clinical) Neurosurgery business 030217 neurology & neurosurgery medicine.drug |
| Zdroj: | Journal of the Neurological Sciences. 399:101-107 |
| ISSN: | 0022-510X |
| DOI: | 10.1016/j.jns.2019.02.004 |
| Popis: | Background Knowledge of adult patients with influenza-associated acute encephalopathy (IAE) is limited. We conducted a detailed survey to investigate the prevalence, clinical features, associated outcomes, and prognostic factors in adult IAE patients. Method A nationwide questionnaire on IAE patients was sent to the departments of Internal Medicine, Neurology, Neurosurgery, and Emergency and Critical Care at all hospitals with ≥200 beds in Japan. Results 118 patients were diagnosed with IAE during the 2013/14 to 2015/16 influenza seasons, and the estimated annual incidence of IAE in Japanese adults was 0.98/1000,000 population. 44 patients were subsequently enrolled in the detailed study. 93% of patients exhibited disturbance of consciousness. Convulsions and delirious behavior were present in 26% and 40% of patients, respectively. 65% of patients received pulse corticosteroid therapy with methylprednisolone and 21% of patients received intravenous gamma-globulin therapy. 63% of patients achieved a good recovery, but 7% died. Multiple logistic regression analysis revealed that plasma glucose level demonstrated a statistically significant association with poor outcome. Conclusion: This nationwide survey provided data for the annual incidence and clinical features of IAE in Japanese adults. Hyperglycemia was indicated as an independent predictor of poor prognosis in IAE patients and reflected systemic hypercytokinemia in IAE pathogenesis. |
| Databáze: | OpenAIRE |
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