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Eur J Paediatr Neurol . Prognostic factor identification and model construction in pediatric influenza-associated encephalopathy: A retrospective ca

tetano

Editor, Senior Moderator
Eur J Paediatr Neurol


. 2026 Jan 10:60:94-100.
doi: 10.1016/j.ejpn.2026.01.001. Online ahead of print. Prognostic factor identification and model construction in pediatric influenza-associated encephalopathy: A retrospective case-control study

Yue Hou[SUP] 1 [/SUP], Wenqin Xie[SUP] 1 [/SUP], Xin Liu[SUP] 1 [/SUP], Weixue Feng[SUP] 1 [/SUP], Xiner Qiu[SUP] 1 [/SUP], Shiman Lin[SUP] 1 [/SUP], Zhu Wu[SUP] 2 [/SUP]



Affiliations
Abstract

Background: To identify risk factors for poor outcomes in IAE and to guide early diagnosis and intervention.
Methods: We retrospectively collected clinical, laboratory, imaging, treatment, and outcome data of children with IAE. Univariate and survival analyses identified prognostic factors and supported the development of a prediction model.
Results: Among 42 children with IAE, 16 (38.1 %) had poor outcomes, including 6 (14.3 %) in-hospital deaths. Poor outcomes were associated with deep coma (75 %), structural brain damage in MRI (86.7 %), and EEG abnormalities (100 %). Univariate analysis revealed that CSF IL-10, CSF pro, blood ALT, AST, CK-MB, and LDL-H were significant discriminators between the good outcome and poor outcome groups (all P < 0.001). Subsequent survival analysis showed AST had the best predictive value, while CK-MB was identified as the only independent risk factor of mortality. A predictive model using optimal cutoffs for AST (>132 IU/L) and CK-MB (>136 IU/L) was developed to stratify patients into good outcome, severe sequelae, and death groups, achieving prediction accuracies of 92.3 %, 100 %, and 66.7 %, respectively.
Conclusion: Our findings indicate that elevated levels of CSF IL-10, CSF pro, and blood AST, ALT, CK-MB, and LDL-H at admission are significantly associated with poor outcomes in pediatric IAE patients. Specifically, AST ≥132 IU/L and CK-MB ≥136 IU/L may serve as early warning indicators of poor outcomes, highlighting the need for timely recognition and intervention in high-risk patients.

Keywords: Early diagnosis; Influenza-associated encephalopathy; Pediatrics; Prognosis.

 
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