Elevated D-dimer on admission may predict poor prognosis in childhood influenza associated encephalopathy
Abstract To determine the risk factors for poor prognosis of influenza-associated encephalopathy (IAE), 56 eligible children with IAE who were treated in the pediatric intensive care unit of Wuhan Children’s Hospital from January 2022 to December 2023 were selected for retrospective analysis and gro...
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2025-01-01
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| author | Huizhen Wang Lingkong Zeng Xingfeng Cheng Hui Li Hong Zhang Yuanmei Shi Yong Zhang Changjian Li |
| author_facet | Huizhen Wang Lingkong Zeng Xingfeng Cheng Hui Li Hong Zhang Yuanmei Shi Yong Zhang Changjian Li |
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| description | Abstract To determine the risk factors for poor prognosis of influenza-associated encephalopathy (IAE), 56 eligible children with IAE who were treated in the pediatric intensive care unit of Wuhan Children’s Hospital from January 2022 to December 2023 were selected for retrospective analysis and grouped according to poor prognosis or not, and independent risk factors for poor prognosis were found by regression analysis. Results showed 26 children (26/30, 46.4%) had a poor prognosis. In the univariate analysis, the poor prognosis group compared with the clinically cured group showed a significant increase in the number of days of hospitalization (3.0 vs. 9.5 days, P < 0.001), high-sensitivity C-reactive protein (6.80 vs. 1.88 mg/L, P = 0.003), interleukin-6 (20.26 vs. 8.24 pg/mL, P = 0.001), interleukin-10 (11.75 vs. 4.72 pg/mL, P = 0.003), alanine aminotransferase (104.0 vs. 20.0 U/L, P = 0.011), aspartate azelotransferase (186.5 vs. 37.0 U/L, P = 0.003), serum albumin (37.99 vs. 40.76 g/L, P = 0.042), prothrombin time (13.2 vs. 11.4 s, P = 0.017), D-dimer (4.34 vs. 0.44 mg/L FEU, P < 0.001), peripheral blood CD19 B-cell count (35.11 vs. 32.75 cells/µL, P = 0.018), and cerebrospinal fluid chloride (126.82 vs. 125.50 mmol/L, P = 0.027) were statistically different in the above 11 indicators. After binary logistic regression analysis, it was concluded that D-dimer was an independent risk factor for poor prognosis (odds ratio = 1.440, 95% confidence interval 1.052–1.972, P = 0.023), and the area under the curve (95% confidence interval) was 0.802 (0.680–0.924), P < 0.001. When D-dimer was ≥ 1.18 mg/L FEU, the occurrence of poor prognosis was predicted with sensitivity and specificity of 65.4% and 96.7%, respectively. In conclusion, IAE has a high incidence of poor prognosis, in which D-dimer is a possible risk factor with discriminatory value in assessing the occurrence of poor prognosis. However, due to the limitations of retrospective single-center small sample size data, more confirmation from multicenter large sample size studies is needed in the future. |
| format | Article |
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| institution | Kabale University |
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| spelling | doaj-art-5b84cb4ba4ff4998b65a3a0f9a5cb62c2025-01-26T12:32:07ZengNature PortfolioScientific Reports2045-23222025-01-0115111010.1038/s41598-025-87690-5Elevated D-dimer on admission may predict poor prognosis in childhood influenza associated encephalopathyHuizhen Wang0Lingkong Zeng1Xingfeng Cheng2Hui Li3Hong Zhang4Yuanmei Shi5Yong Zhang6Changjian Li7Department of Neonatal Intensive Care Unit, Wuhan Children’s Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, , Huazhong University of Science and TechnologyDepartment of Neonatal Intensive Care Unit, Wuhan Children’s Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, , Huazhong University of Science and TechnologyDepartment of Pediatric Intensive Care Unit, Wuhan Children’s Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Epidemiology and Statistics, Taixing People’s HospitalDepartment of Neonatal Intensive Care Unit, Taixing People’s HospitalDepartment of Neonatal Intensive Care Unit, Taixing People’s HospitalDepartment of Cardiology, Wuhan Children’s Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Cardiology, Wuhan Children’s Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and TechnologyAbstract To determine the risk factors for poor prognosis of influenza-associated encephalopathy (IAE), 56 eligible children with IAE who were treated in the pediatric intensive care unit of Wuhan Children’s Hospital from January 2022 to December 2023 were selected for retrospective analysis and grouped according to poor prognosis or not, and independent risk factors for poor prognosis were found by regression analysis. Results showed 26 children (26/30, 46.4%) had a poor prognosis. In the univariate analysis, the poor prognosis group compared with the clinically cured group showed a significant increase in the number of days of hospitalization (3.0 vs. 9.5 days, P < 0.001), high-sensitivity C-reactive protein (6.80 vs. 1.88 mg/L, P = 0.003), interleukin-6 (20.26 vs. 8.24 pg/mL, P = 0.001), interleukin-10 (11.75 vs. 4.72 pg/mL, P = 0.003), alanine aminotransferase (104.0 vs. 20.0 U/L, P = 0.011), aspartate azelotransferase (186.5 vs. 37.0 U/L, P = 0.003), serum albumin (37.99 vs. 40.76 g/L, P = 0.042), prothrombin time (13.2 vs. 11.4 s, P = 0.017), D-dimer (4.34 vs. 0.44 mg/L FEU, P < 0.001), peripheral blood CD19 B-cell count (35.11 vs. 32.75 cells/µL, P = 0.018), and cerebrospinal fluid chloride (126.82 vs. 125.50 mmol/L, P = 0.027) were statistically different in the above 11 indicators. After binary logistic regression analysis, it was concluded that D-dimer was an independent risk factor for poor prognosis (odds ratio = 1.440, 95% confidence interval 1.052–1.972, P = 0.023), and the area under the curve (95% confidence interval) was 0.802 (0.680–0.924), P < 0.001. When D-dimer was ≥ 1.18 mg/L FEU, the occurrence of poor prognosis was predicted with sensitivity and specificity of 65.4% and 96.7%, respectively. In conclusion, IAE has a high incidence of poor prognosis, in which D-dimer is a possible risk factor with discriminatory value in assessing the occurrence of poor prognosis. However, due to the limitations of retrospective single-center small sample size data, more confirmation from multicenter large sample size studies is needed in the future.https://doi.org/10.1038/s41598-025-87690-5Influenza-associated encephalopathyInfluenzaAcute encephalopathyAcute necrotizing encephalopathyPoor prognosisChildren |
| spellingShingle | Huizhen Wang Lingkong Zeng Xingfeng Cheng Hui Li Hong Zhang Yuanmei Shi Yong Zhang Changjian Li Elevated D-dimer on admission may predict poor prognosis in childhood influenza associated encephalopathy Scientific Reports Influenza-associated encephalopathy Influenza Acute encephalopathy Acute necrotizing encephalopathy Poor prognosis Children |
| title | Elevated D-dimer on admission may predict poor prognosis in childhood influenza associated encephalopathy |
| title_full | Elevated D-dimer on admission may predict poor prognosis in childhood influenza associated encephalopathy |
| title_fullStr | Elevated D-dimer on admission may predict poor prognosis in childhood influenza associated encephalopathy |
| title_full_unstemmed | Elevated D-dimer on admission may predict poor prognosis in childhood influenza associated encephalopathy |
| title_short | Elevated D-dimer on admission may predict poor prognosis in childhood influenza associated encephalopathy |
| title_sort | elevated d dimer on admission may predict poor prognosis in childhood influenza associated encephalopathy |
| topic | Influenza-associated encephalopathy Influenza Acute encephalopathy Acute necrotizing encephalopathy Poor prognosis Children |
| url | https://doi.org/10.1038/s41598-025-87690-5 |
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