Prognostic Factors in Influenza-associated Encephalopathy

Nagao, Takashi; Morishima, Tsuneo; Kimura, Hiroshi; Yokota, S; Yamashita, Nobuko; Ichiyama, Takashi; Kurihara, Mana; Miyazaki, Chiaki; Okabe, Nobuhiko

doi:10.1097/inf.0b013e318162a13b

Cited by 61 publications

(51 citation statements)

References 20 publications

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“…A retrospective cohort study in Japan suggested that NSAID use, specifically the use of mefenamic acid and diclofenac, was associated with increased mortality from influenza-associated encephalopathy in children (6). In 184 cases of influenza encephalopathy, the adjusted odds ratios for mortality with acetaminophen, diclofenac, and mefenamic acid were 1.46 (0.38-5.56), 16.34 (1.27-210), and 9.44 (0.70-128), respectively.…”

Section: Discussionmentioning

confidence: 99%

“…Mefenamic acid and diclofenac were reported by Nagao et al to be associated with encephalopathy mortality in pediatric patients hospitalized for seasonal (non-pH1N1) influenza in Japan (6). Based on that finding, we explored whether NSAID and ASA use before admission to intensive care among patients with pH1N1 influenza was associated with mortality in adults and children.…”

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confidence: 99%

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Nonsteroidal Anti-Inflammatory Drug and Aspirin Use, and Mortality among Critically Ill Pandemic H1N1 Influenza Patients: an Exploratory Analysis

et al. 2016

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SUMMARY:We explored nonsteroidal anti-inflammatory drug (NSAID) and aspirin (ASA) use and mortality in the U.S. Department of Health and Human Services' registry of 683 adult and 838 pediatric critically ill pandemic 2009 H1N1 influenza (pH1N1) patients. Among adults, 88 (12.9z) and 101 (14.8z) reported pre-admission use of an NSAID and ASA, respectively; mortality was similar (23-24z) regardless of NSAID or ASA use. Mortality among 89 pediatric NSAID users and 749 nonusers did not differ significantly (10.1z and 8.8z, respectively). One of 16 pediatric ASA users died. Among pediatric patients, the adjusted relative risk estimate for NSAID use and 90-day mortality was higher when influenza vaccination was included in the model (risk ratio [RR] ＝ 1.5; 95z confidence interval, 0.7-3.2), although not statistically significant. Among adults, RR estimates did not change appreciably after adjusting for age, sex, health status, or vaccine status. We found no compelling evidence that NSAID or ASA use influenced mortality in severe pH1N1.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Nonsteroidal Anti-Inflammatory Drug and Aspirin Use, and Mortality among Critically Ill Pandemic H1N1 Influenza Patients: an Exploratory Analysis

et al. 2016

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“…Some of these values were evaluated in previous studies as prognostic factors of acute encephalopathy. 6,7 Nagao et al 6 revealed that elevated AST levels, hyperglycemia, the presence of hematuria or proteinuria, and the use of diclofenac sodium were associated with poor outcomes in children with influenza-associated encephalopathy. Bottom: Five days after the onset, T1WI and T2WI images demonstrate marked edematous changes in the entire cortex.…”

Section: Methodsmentioning

confidence: 99%

Differences of Clinical Manifestations According to the Patterns of Brain Lesions in Acute Encephalopathy with Reduced Diffusion in the Bilateral Hemispheres

Okumura¹,

Kidokoro²,

Tsuji³

et al. 2009

AJNR Am J Neuroradiol

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“…41°C were found to be significant according to a univariate analysis (9). Because the patient had reported the daily use of an electric heating blanket during the night, we speculated that her body temperature may have been unusually elevated.…”

Section: Discussionmentioning

confidence: 99%

Fatal Encephalopathy Associated with Influenza in a Health Care Professional

et al. 2016

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A 41-year-old nurse was referred to our hospital with a fever and disturbed consciousness. She tested positive for influenza antigen. CT and MRI findings revealed low density and intensity areas in the right occipital and lateral lobes with remarkable brain edema, which led to a diagnosis of influenza encephalopathy. Influenza A antibodies in the serum were below the detection limit despite the patient receiving previous vaccination three months earlier. A PCR analysis revealed that the influenza HA gene was classified into clade 3C.2a, subclass AH3N2. The present case indicates the potential development of encephalopathy in adults under certain conditions.

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Prognostic Factors in Influenza-associated Encephalopathy

Abstract: We identified patients who had factors associated with a poor prognosis, and these findings might be clinically useful for the management of this illness.

Cited by 61 publications

References 20 publications

Nonsteroidal Anti-Inflammatory Drug and Aspirin Use, and Mortality among Critically Ill Pandemic H1N1 Influenza Patients: an Exploratory Analysis

Nonsteroidal Anti-Inflammatory Drug and Aspirin Use, and Mortality among Critically Ill Pandemic H1N1 Influenza Patients: an Exploratory Analysis

Differences of Clinical Manifestations According to the Patterns of Brain Lesions in Acute Encephalopathy with Reduced Diffusion in the Bilateral Hemispheres

Fatal Encephalopathy Associated with Influenza in a Health Care Professional

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