Influenza-associated encephalopathy syndrome (IAES) is a critical neuroinflammatory condition in pediatric influenza, characterized by abrupt consciousness decline, frequent seizures, or localized neurological deficits during high fever. This study aimed to identify risk factors and develop a predictive model for IAES in children with fever and convulsions.
A retrospective analysis of 623 pediatric influenza cases was conducted, and the results showed that frequency of seizures, timing of the first seizure, increased respiratory rate, elevated procalcitonin levels, decreased albumin levels, and reduced CD4+/CD8 + ratio were independent risk factors for IAES. A nomogram predictive model was constructed using these risk factors, demonstrating good discrimination and calibration.
The study found that frequent convulsions increase the risk of IAES by 1.467 times compared to single convulsions. The timing of the first seizure during the febrile period is also an important risk factor for worsening and mortality of acute necrotizing encephalopathy syndrome. Elevated procalcitonin levels and decreased albumin levels were correlated with disease severity.
This study provides a framework for IAES risk stratification in China, addressing a critical gap in pediatric neuro-infectious disease management. The predictive model can help clinicians assess risk and guide treatment strategies for children with fever and convulsions. However, further validation is necessary to confirm the results and ensure generalizability across diverse populations.
Data availability:
The datasets used and/or analyzed during the current study are available from the corresponding author upon reasonable request.
Abbreviations:
* IAES: Influenza-associated encephalopathy syndrome
* ANES: Acute necrotizing encephalopathy syndrome
* ROC: Receiver operating characteristic curve
* MSE: Mean square error
* DFOC: Day of fever course when first convulsion occurred
* RR: Respiration rate
Source: https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-025-11681-0