Table 1.
Risk factors for severe HFMD
| Relevant factors | Mild group n = 88 (%) |
Severe group n = 128 (%) |
P |
|---|---|---|---|
| Gender | 0.817 | ||
| Male | 55 (62.5) | 78 (60.9) | |
| Female | 33 (37.5) | 50 (39.1) | |
| Age (years) | 0.557 | ||
| ≤ 3 | 65 (73.9) | 99 (77.3) | |
| 3–6 | 23 (26.1) | 29 (22.7) | |
| Fever | 81 (92.0) | 128 (100.0) | 0.001** |
| Temperature (°C) | 0.000*** | ||
| 37.3 to ≤38 | 8 (9.1) | 0 (0) | |
| 38–39 | 38 (43.2) | 21 (16.4) | |
| 39–40 | 42 (47.7) | 107 (83.6) | |
| Duration of fever (day) | |||
| ≤ 3 | 65 (73.9) | 39 (30.5) | 0.000*** |
| > 3 | 23 (26.1) | 89 (69.5) | |
| Hypersomnia | 2 (2.3) | 118 (92.2) | 0.000*** |
| Hyperarousal | 38 (43.2) | 121 (94.5) | 0.000*** |
| Limb shaking | 5 (5.7) | 98 (76.6) | 0.000*** |
| Convulsion | 2 (2.3) | 33 (25.8) | 0.000*** |
| Vomiting | 16 (18.2) | 87 (68.0) | 0.000*** |
| Dyspnoea | 0 (0) | 71 (55.5) | - |
| Pathologic reflexes | 0 (0) | 128 (100.0) | - |
| Consciousness disorder | 0 (0) | 75 (58.6) | - |
| Increased blood pressure | 0 (0) | 65 (50.8) | - |
| Circulatory disturbance | 0 (0) | 75 (58.6) | - |
| Laboratory examination | |||
| Peripheral WBC count > 15 × 109/L | 12 (13.6) | 56 (43.8) | 0.000*** |
| Fasting blood glucose level > 8.3 mmol/L | 1 (1.1) | 62 (48.4) | 0.000*** |
| EV71-positivity | 11 (12.5) | 75 (58.6) | 0.000*** |
| NT-proBNP (log10 pg/mL) | 2.18 ± 0.35 | 3.07 ± 0.75 | 0.000*** |
| NT-proBNP >125 pg/mL | 49 (55.7) | 120 (93.8) | 0.000*** |
| Increased CK | 3 (3.4) | 31 (24.2) | 0.000*** |
| Increased CK-MB | 36 (40.9) | 58 (45.3) | 0.521 |
| Increased LDH | 2 (2.3) | 18 (14.1 %) | 0.001** |
| Increased PCT | 22 (25.0) | 71 (55.5 %) | 0.000*** |
| Deatha | 0 (0) | 45 (35.2 %) | - |
| Treatment | Symptomatic treatment | Symptomatic treatment, glucocorticoid, IVIG, complication therapy | - |
HFMD hand, foot, and mouth disease, EV71 enterovirus 71, WBC White blood cell, NT-proBNP N-terminal of the prohormone brain natriuretic peptide, CK Creatine kinase isoenzyme, CK-MB Creatine kinase isoenzymeMB, LDH Lactate dehydrogenase, PCT procalcitonin, IVIG Intravenous immunoglobulins
aCauses of death were acute pulmonary edema, brainstem encephalitis and circulatory failure
*P <0.05, **P <0.01,***P <0.001