Functional outcomes in adult patients with herpes simplex encephalitis admitted to the ICU: a multicenter cohort study
| Autor: | M. Alves, Noelle Brule, P. Jaquet, Frédérique Barbier, de Montmollin E, Da Silva D, Kalioubi Ae, Sâmea Keise de Oliveira Silva, Jean-Marc Tadié, Marie Conrad, Charline Sazio, Claire Dupuis, Pierre Bailly, Laurent Argaud, Susset, Michel Wolff, J. F. Timsit, Lila Bouadma, D. Daubin, Benjamine Sarton, Romain Sonneville, Sophie Demeret, R. Chabane, Nicolas Lerolle |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Critical Care and Intensive Care Medicine Logistic regression Cohort Studies 03 medical and health sciences 0302 clinical medicine Modified Rankin Scale Internal medicine Anesthesiology Outcome Assessment Health Care medicine Humans Aged Retrospective Studies Mechanical ventilation Adult patients business.industry Glasgow Coma Scale 030208 emergency & critical care medicine Middle Aged Physical Functional Performance medicine.disease Hospitalization Intensive Care Units 030228 respiratory system Female Encephalitis Herpes Simplex France business Encephalitis Cohort study |
| Zdroj: | Intensive Care Medicine. 45:1103-1111 |
| ISSN: | 1432-1238 0342-4642 |
| Popis: | We aimed to study the association of body temperature and other admission factors with outcomes of herpes simplex encephalitis (HSE) adult patients requiring ICU admission. We conducted a retrospective multicenter study on patients diagnosed with HSE in 47 ICUs in France, between 2007 and 2017. Fever was defined as a body temperature higher or equal to 38.3 °C. Multivariate logistic regression analysis was used to identify factors associated with poor outcome at 90 days, defined by a score of 3–6 (indicating moderate-to-severe disability or death) on the modified Rankin scale. Overall, 259 patients with a score on the Glasgow coma scale of 9 (6–12) and a body temperature of 38.7 (38.1–39.2) °C at admission were studied. At 90 days, 185 (71%) patients had a poor outcome, including 44 (17%) deaths. After adjusting for age, fever (OR = 2.21; 95% CI 1.18–4.16), mechanical ventilation (OR = 2.21; 95% CI 1.21–4.03), and MRI brain lesions > 3 lobes (OR = 3.04; 95% CI 1.35–6.81) were independently associated with poor outcome. By contrast, a direct ICU admission, as compared to initial admission to the hospital wards (i.e., indirect ICU admission), was protective (OR = 0.52; 95% CI 0.28–0.95). Sensitivity analyses performed after adjustment for functional status before admission and reason for ICU admission yielded similar results. In HSE adult patients requiring ICU admission, several admission factors are associated with an increased risk of poor functional outcome. The identification of potentially modifiable factors, namely, elevated admission body temperature and indirect ICU admission, provides an opportunity for testing further intervention strategies. |
| Databáze: | OpenAIRE |
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