Severe Acute Neurologic Involvement in Children With Hemolytic-Uremic Syndrome.
Pediatrics
; 147(3)2021 03.
Article
en En
| MEDLINE
| ID: mdl-33579812
ABSTRACT
BACKGROUND AND OBJECTIVES:
Acute severe neurologic involvement is the most threatening complication in children with hemolytic-uremic syndrome (HUS). Our primary study objectives were to describe the association between acute neurologic manifestations (ANMs) and in-hospital mortality among children with HUS.METHODS:
Using the Pediatric Health Information System database, in this retrospective multicenter cohort study, we identified the first HUS-related inpatient visit among children ≤18 years (years 2004-2018). Frequency of selected ANMs and combinations of ANMs, as well as the rate of mortality, was calculated. Multivariate logistic regression was used to identify the association of ANMs and the risk of in-hospital mortality.RESULTS:
Among 3915 patients included in the analysis, an ANM was noted in 10.4% (n = 409) patients. Encephalopathy was the most common ANM (n = 245). Mortality was significantly higher among patients with an ANM compared with patients without an ANM (13.9% vs 1.8%; P < .001). Individuals with any ANM had increased odds of mortality (odds ratio [OR] 2.25; 95% confidence interval [CI] 1.29-3.93; P = .004), with greater risk (OR 2.60; 95% CI 1.34-5.06; P = .005) among patients with ≥2 manifestations. Brain hemorrhage (OR 3.09; 95% CI 1.40-6.82; P = .005), brain infarction (OR 2.64; 95% CI 1.10-6.34; P = .03), anoxic brain injury (OR 3.92; 95% CI 1.49-10.31; P = .006), and brain edema (OR 4.81; 95% CI 1.82-12.71; P = .002) were independently associated with mortality.CONCLUSIONS:
In this study, the largest systematic assessment of ANMs among children with HUS to date, we identify differences in in-hospital mortality based on the type of ANM, with increased risk observed for patients with multiple ANMs.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
1_ASSA2030
Problema de salud:
1_sistemas_informacao_saude
Asunto principal:
Encefalopatías
/
Mortalidad Hospitalaria
/
Síndrome Hemolítico-Urémico
Tipo de estudio:
Etiology_studies
/
Observational_studies
Límite:
Adolescent
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Child
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Child, preschool
/
Female
/
Humans
/
Infant
/
Male
/
Newborn
Idioma:
En
Revista:
Pediatrics
Año:
2021
Tipo del documento:
Article