1
|
Wang P, Chen Y, Wan G, Liu H, Liu L, Wen D, Yan Y, Wang Y, Li X, Yang Q, Zhang W. Effects of adjunctive Chinese patent medicine on outcome of viral encephalitis in children: A multicenter retrospective study in China. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2024; 124:155303. [PMID: 38176272 DOI: 10.1016/j.phymed.2023.155303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 12/06/2023] [Accepted: 12/17/2023] [Indexed: 01/06/2024]
Abstract
BACKGROUND Some patients with viral encephalitis in China seek treatment with Chinese patent medicine (CPM) to improve their symptoms, but few studies have focused on the impact of CPM on the prognosis of viral encephalitis (VE). The aim of this multicenter retrospective study was to assess the benefit of adjunctive CPM therapy on the outcome of children with VE in China. METHODS This study retrospectively included 834 children with viral encephalitis who were hospitalized at five medical institutions from 2018 to 2021. Univariate and multivariate logistic regression was used to assess the effect of CPM on sequelae in patients with VE. 1:1 propensity score matching was used to exclude the effect of confounding factors. Forest plots were used to observe the effect of CPM on the prognosis of VE in different subgroups. RESULTS There were fewer patients with sequelae in the group of patients using CPM regardless of whether they were matched or not. The results of multivariate logistic regression analysis showed that the use of CPM was an independent protective factor for the development of sequelae in VE patients (OR = 0.063, 95 % CI: 0.011-0.350, p = 0.002). Subgroup analyses showed that CPM was a protective factor for the development of sequelae regardless of the presence or absence of coma and comorbidities. In addition, we evaluated other outcome indicators and found shorter duration of illness, fever and headache in children with EV in the CPM group. CONCLUSION Adjunctive CPM therapy may significantly reduce sequelae in children with VE, as well as effectively alleviate patients' clinical symptoms. However, more prospective studies and clinical trials are needed to further evaluate its efficacy and safety.
Collapse
Affiliation(s)
- Peng Wang
- Center of Infectious Disease, Beijing Ditan Hospital, Capital Medical University, No. 8 Jing Shun East Street, Beijing 100015, China
| | - Yang Chen
- Department of Pediatrics, Liaocheng People's Hospital, No.67 Dongchang West Street, Liaocheng, Shandong 252004, China
| | - Gang Wan
- Center of Infectious Disease, Beijing Ditan Hospital, Capital Medical University, No. 8 Jing Shun East Street, Beijing 100015, China
| | - Huazhang Liu
- Department of Pediatrics, The First Affiliated Hospital of Shandong First Medical University, Shandong 250013, China
| | - Li Liu
- Department of Neurology, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
| | - Danning Wen
- Wuhan Jinyintan Hospital Infected Ward One, Hubei 430048, China
| | - Yibin Yan
- Department of Pediatrics, The First Affiliated Hospital of Shandong First Medical University, Shandong 250013, China
| | - Yingyan Wang
- Department of Neurology, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
| | - Xin Li
- Center of Infectious Disease, Beijing Ditan Hospital, Capital Medical University, No. 8 Jing Shun East Street, Beijing 100015, China.
| | - Qiaozhi Yang
- Department of Pediatrics, Liaocheng People's Hospital, No.67 Dongchang West Street, Liaocheng, Shandong 252004, China.
| | - Wei Zhang
- Center of Infectious Disease, Beijing Ditan Hospital, Capital Medical University, No. 8 Jing Shun East Street, Beijing 100015, China.
| |
Collapse
|
2
|
Thy M, de Montmollin E, Bouadma L, Timsit JF, Sonneville R. Severe meningoencephalitis: epidemiology and outcomes. Curr Opin Crit Care 2023; 29:415-422. [PMID: 37641514 DOI: 10.1097/mcc.0000000000001087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
PURPOSE OF REVIEW This article aims to provide an updated review on the epidemiology and outcomes of severe meningoencephalitis. RECENT FINDINGS Meningoencephalitis is a critical medical condition characterized by inflammation in both the meninges and brain parenchyma. Bacterial, viral, or fungal infections are common causes, although noninfectious factors, such as autoimmune causes, can also contribute. In patients requiring intensive care, meningoencephalitis is associated with a severe prognosis, including mortality rates ranging from 11 to 25% and functional disability in 15-25% of survivors. Recent multicenter studies have identified several parameters linked to poor outcomes, including older age, immunocompromised status, focal neurologic signs, abnormal brain imaging, and delayed administration of antimicrobials. The use of new multiplex PCR techniques for diagnosis has generated debate based on recent data. Investigation is still needed to determine the effectiveness of adjunctive therapies, including seizure prophylaxis, and adjunctive steroids for nonbacterial causes. SUMMARY Recent multicenter studies have enhanced our understanding of the current epidemiology and outcomes of severe meningoencephalitis in adult patients.
Collapse
Affiliation(s)
- Michael Thy
- Department of Intensive Care Medicine
- Department of Infectious and Tropical Diseases, AP-HP, Bichat Hospital
- EA 7323 - Pharmacology and Therapeutic Evaluation in Children and Pregnant Women
| | - Etienne de Montmollin
- Department of Intensive Care Medicine
- INSERM UMR1137, IAME, Université de Paris Cité, Paris, France
| | - Lila Bouadma
- Department of Intensive Care Medicine
- INSERM UMR1137, IAME, Université de Paris Cité, Paris, France
| | - Jean-François Timsit
- Department of Intensive Care Medicine
- INSERM UMR1137, IAME, Université de Paris Cité, Paris, France
| | - Romain Sonneville
- Department of Intensive Care Medicine
- INSERM UMR1137, IAME, Université de Paris Cité, Paris, France
| |
Collapse
|