The risk factors of critical hand, foot and mouth disease

Abstract

Objective To explore the risk factors of severe hand, foot and mouth disease(HFMD)that progressed to critical illness among children. Methods The clinical data of 100 cases with severe and critical HFMD(82 cases were severe HFMD and 18 cases were critical)treated in the First Affiliated Hospital of Guangxi Medical University from January 2009 to September 2010 were analyzed retrospectively.We used univariate and multiple non-conditional Logistic regression analysis to compare the differences of the clinical features and laboratory examination between two groups, survey the risk factors of severe HFMD progressing. Results Most of the patients in both groups were under 5 years old, mainly under 3 years old which accounted for 85.4% of severe HFMD cases and 88.9% of critical HFMD cases.The dominant sex was male in both groups, the sex ratio were 2.28∶1 and 8.00∶1.The main pathogen was enteral virus 71.Fever and rash were found in most of the severe and critical patients.The main neurological symptoms were myoclonus, tremors, limb asthenia, somnolence, vomiting and convulsion.Nervous system symptoms in critical cases were even worse to develop to coma and accompany with serious respiratory and circulatory manifestations.Univariate analysis showed that age<2 years, tachycardia, tachypnea, elevated leukocyte count, platelet count and blood glucose level, persistent high fever, limb asthenia, pulmonary moist rales and changes on chest radiograph were the risk factors that progressed to critical illness.The multiple non-conditional Logistic regression analysis showed that age<2 years, tachycardia, limb asthenia and pulmonary moist rales were independent risk factors for severe HFMD cases progressing to critical illness. Conclusion The patients aged<2-year-old, tachycardia, limb asthenia and pulmonary moist rales are closely related to severe HFMD cases progressing to fatal condition. Key words: Hand, foot and mouth disease; Severe and critical; Risk factor,