Acute febrile encephalopathy and its outcome among children in a tertiary care hospital

Abstract

Background: Acute febrile encephalopathy (AFE) is a common condition leading to hospitalization of children in India. Majority of the studies revealed etiology of AFE, but very few studies emphasized on predictors of mortality. This study was conducted to observe the outcome in relation to etiology and Glasgow coma score at admission.Methods: This prospective study was carried out on 84 children between 2 months to 14 years, with fever duration of <14 days, GCS ≤12 at the time of admission and altered sensorium in the pediatric intensive care unit over a period of 18 months (December 2011 to June 2013). Patients were evaluated daily till discharge/death. Outcome was evaluated in terms of complete recovery, morbidity and mortality.Results: In this study, AFE was higher among the age group of 6-14 years (54.7%) with most common cause being viral encephalitis (38%). Higher mortality rates were observed in CNS infections. Persistent seizures and hemiparesis were the most common causes of morbidity. GCS at initial presentation <7 was significantly associated with mortality, p value being 0.036.Conclusions: CNS infections are the leading cause of febrile encephalopathy and also associated with high mortality. Persistent seizures and hemiparesis being most common causes of morbidity. Low GCS at the time of admission and longer duration of coma are associated with higher risk of morality. Most of the morbidities were observed in CNS infections and as most of them were curable, early institution of appropriate treatment will decrease morbidity.