Table 3.
Determinants of an unfavourable outcome at discharge (or earlier if patient died) using data from baseline (ie, day 1) and day 2 after inclusion
| Unfavourable outcome (n=236)* | Favourable outcome (n=428)† | Univariate odds ratio for unfavourable outcome (95% CI) | p value | Multivariate odds ratio for unfavourable outcome (95% CI) | p value | ||
|---|---|---|---|---|---|---|---|
| More than 1 week between symptom onset and hospital admission | 43/235 (18%) | 35/393 (9%) | 2·50 (1·55 to 4·05) | 0·0002 | 3·03 (1·68 to 5·48) | 0·0002 | |
| Rainy season‡ | 158/236 (67%) | 256/428 (60%) | 1·36 (0·98 to 1·90) | 0·079 | .. | .. | |
| Clinical features | |||||||
| Cough | 94/234 (40%) | 135/425 (32%) | 1·44 (1·03 to 2·01) | 0·033 | .. | .. | |
| Abnormal lung examination | 53/236 (22%) | 36/428 (8%) | 3·14 (1·99 to 5·01) | 0·0002 | .. | .. | |
| Shortness of breath | 65/227 (29%) | 63/418 (15%) | 2·26 (1·52 to 3·35) | <0·0001 | 1·86 (1·15 to 3·00) | 0·011 | |
| Costal indrawing | 27/233 (12%) | 17/428 (4%) | 3·15 (1·69 to 6·04) | 0·0003 | .. | .. | |
| Generalised seizures | 101/233 (43%) | 144/423 (34%) | 1·48 (1·07 to 2·06) | 0·023 | .. | .. | |
| Limb weakness | 161/234 (69%) | 213/423 (50%) | 2·17 (1·55 to 3·05) | <0·0001 | 1·69 (1·12 to 2·57) | 0·013 | |
| Dysautonomia | 12/231 (5%) | 10/424 (2%) | 2·26 (0·95 to 5·49) | 0·069 | .. | .. | |
| Abnormal limb reflex | 163/227 (72%) | 186/410 (45%) | 3·06 (2·17 to 4·36) | <0·0001 | 2·83 (1·86 to 4·31) | <0·0001 | |
| Abnormal sensory function | 45/215 (21%) | 37/410 (9%) | 2·66 (1·66 to 4·29) | <0·0001 | .. | .. | |
| Cranial nerve palsy presence | 27/214 (13%) | 31/405 (8%) | 1·74 (1·00 to 3·01) | 0·058 | .. | .. | |
| Coma (GCS ≤8) at day 2 | 120/232 (52%) | 61/427 (14%) | 6·40 (4·42 to 9·35) | <0·0001 | 2·90 (1·78 to 4·72) | <0·0001 | |
| Intubation | 34/236 (14%) | 18/428 (4%) | 3·81 (2·12 to 7·07) | <0·0001 | .. | .. | |
| Supplemental oxygen | 118/232 (51%) | 100/427 (23%) | 3·38 (2·40 to 4·76) | <0·0001 | 1·89 (1·25 to 2·86) | 0·0023 | |
| Biological and radiological features | |||||||
| Pleiocytosis (>5 cells per μL) | 124/236 (53%) | 268/428 (63%) | 0·66 (0·48 to 0·91) | 0·013 | 0·57 (0·38 to 0·86) | 0·0067 | |
| CSF glucose concentration <2·2mmol/L | 32/235 (14%) | 41/419 (10%) | 1·45 (0·88 to 2·38) | 0·15 | .. | .. | |
| CSF protein concentration >1g/L | 37/236 (16%) | 45/423 (11%) | 1·56 (0·97 to 2·49) | 0·065 | 1·82 (1·02 to 3·22) | 0·041 | |
| Abnormal CNS imaging | 198/217 (91%) | 307/386 (80%) | 2·66 (1·59 to 4·66) | 0·0001 | .. | .. | |
| Difference between GCS on day 2 and at baseline | 0 (−2 to 1) | 0 (0 to 2) | 0·75 (0·69 to 0·81) | <0·0001 | 0·82 (0·74 to 0·91) | 0·0002 | |
| Pathogens | |||||||
| RSV in nasopharyngeal swab | 13/235 (6%) | 8/428 (2%) | 3·05 (1·25 to 7·90) | 0·018 | 2·49 (0·88 to 7·05) | 0·086 | |
| Parainfluenza 4 in nasopharyngeal swabs | 11/235 (5%) | 8/428 (2%) | 2·56 (1·01 to 6·79) | 0·050 | .. | .. | |
| Mycobacterium tuberculosis-associated encephalitis | 11/236 (5%) | 7/428 (2%) | 2·91 (1·12 to 8·14) | 0·026 | 3·23 (1·04 to 10·03) | 0·043 | |
| Bacterial encephalitis | 8/236 (3%) | 33/428 (8%) | 0·43 (0·18 to 0·90) | 0·028 | .. | .. | |
Outcomes are either n/N (%) or median (IQR). All variables were entered in the multivariable logistic regression model simultaneously; we then did backward selection on this model, stopping when the Akaike information criterion reached its minimum, and we report only p values and odds ratios with their 95% CIs for variables retained in the final model. CSF=cerebrospinal fluid. GCS=Glasgow coma scale. RSV=respiratory syncytial virus.
Death or a Liverpool outcome score of 1 (death) or 2 (severe neurological sequalae) at discharge.
Liverpool outcome score >2.
Rainy season is the period between May 1 and Oct 31.