Abstract P-135: MULTICENTER CLINICAL EPIDEMIOLOGIC STUDY OF SEVERE HAND FOOT AND MOUTH DISEASE.

Abstract

Aims & Objectives: We conducted a multicenter epidemiological survey of critical hand foot and mouth disease (HFMD), to find out the treatment outcomes and disease burden in severe HFMD. Methods A collaborative study group was established including children’s hospital of Fudan university, Jiangxi provincial children’s hospital, Anhui provincial children’s hospital, Linyi people’s hospital and No. 2 people’s hospital of Fuyang city. Clinical dates of severe HFMD were prospective collected. Results We collected 226 severe HFMD cases from April 2014 to October 2016. EV71 virus positive accounted for 70.9%. 97.8% were given mannitol, 40.3% glycerol fructose. 87.6% were given IVIG, IVIG use in stage 2, 3, 4 was 82.8%, 96.7%, 89.2% respectively. 84.1% were given antivirus therapy, antivirus drug use in stage 2, 3, 4 was 78.9%, 93.4, 86.5% respectively. 64.2% were given hormone therapy.47.8% needed milrinone, 27.4% needed Phentolamine, vasoactive agent use in stage 2, 3, 4 was 46.1%, 93.4, 91.9% respectively. 30.5% received CPAP, 40.3% with mechanical ventilation,The mean mechanical ventilation time was 125.9 ± 101.8 hours. Hormone, IVIG, antivirus agent did not reduce the mortality of severe HFMD patients. 11 cases died or died after giving up. Length of stay in hospital were 9.18 ± 5.16 (1–37) days. Multivariate analysis found that respiratoy rhythm abnormality, CRT more than 3 seconds were risk factors for the deaths in the severe HFMD. Conclusions The children in stage 3, 4 needed more IVIG, antivirus drugs, vasoactive drugs, mechanical ventilation compared with stage 2. The lenth of mechanical ventilation and hospital stay was higher in stage 3, 4 compared to stage 2.