Risk factors for severe hand, foot and mouth disease

WU Cheng-jiu

Abstract：Objective To investigate the risk factors of severe hand, foot and mouth disease (HMFD), so as to provide evidence for predicting disease condition and choosing the reasonable treatment. Methods A total of 116 HFMD patients with complete medical record, who had been admitted, diagnosed and treated systematically in our hospital from Jan. 2008 to Jun. 2013, were enrolled in the study, including 39 patients with severe HFMD (severe group), and 77 patients with ordinary HFMD (ordinary group). Twenty-one potential factors associated with the occurrence of severe HFMD were evaluated by univariate and multivariate logistic regression analysis. Results As compared with the ordinary group, the children of the severe group were younger, mainly chose community hospital or individual clinic for their first visit, had shorter interval from HFMD onset to the first visit, and were more likely to suffer from respiratory disease one month before HFMD onset (P<0.05); the severe group had a higher proportion of patients with fever (more severe condition and longer duration), a more frequent occurrence of vomiting, less occurrence of hand rash, mouth ulcers or herpes, but greater likelihood of the occurrence of neurological symptoms such as drowsiness and hand or leg trembling (P<0.05); the severe group had greater number of patients with higher blood sugar and WBC count of >10.8 ×109/L, and suffering from enterovirus (EV) 71 infection (P<0.05). The factors including sex, premature birth, low birth weight, cough, foot rash and the percentage of neu-trophils were not significantly different between the severe group and the ordinary group (P>0.05). Multivariate logistic regression analysis showed that the independent risk factors of severe HFMD included the age of <1 year old, the interval from HFMD onset to the first visit≤1 day, WBC count of>10.8×109/L, vomiting and EV71 infection (OR:1.982, 2.296, 2.359, 5.553 and 13.127, respectively, P<0.05). Conclusions The occurrence of severe HFMD is correlated with many factors, and it is suggested that efforts should be made in screening various risk factors strictly, and predicting the disease condition early.