The evaluation value of disturbance coefficient combined with bedside continuous video electroencephalogram for the short-term prognosis of severe encephalitis in children

Exploring the value of non-invasive brain edema monitoring combined with bedside video electroencephalography in evaluating the short-term prognosis of children with severe encephalitis. This study retrospectively analyzed the clinical data of 136 children diagnosed with severe encephalitis in the Intensive Care Medicine Department of Hebei Children's Hospital from January 2021 to July 2024. According to the prognosis at discharge, patients were divided into a poor prognosis group (54 cases) and a good prognosis group (82 cases). Compare the clinical manifestations, modified GCS scores, early warning scores, clinical indicators monitored after admission, DC values, and video electroencephalography between two groups of children. Logistic regression was used to analyze the risk factors for poor prognosis, and receiver operating characteristic (ROC) curves and decision curve analysis (DCA) were used to analyze the predictive value and clinical net benefit of DC, video EEG, and their combined evaluation of prognosis. There was a statistically significant difference (P<0.05) in the modified GCS score, early warning score, lactate dehydrogenase, blood ammonia, and abnormal cranial imaging between the two groups of patients. The DC values monitored at admission in the poor prognosis group were significantly lower than those in the good group, with 22 cases (40.7%) having severe EEG abnormalities, and the difference was statistically significant (P<0.05). GCS score, early warning score DC,severe abnormal video electroencephalogram is a risk factor for poor prognosis in children with severe encephalitis. The area under the ROC curve for predicting the prognosis of children with severe encephalitis using DC values is 0.734, with an optimal cutoff value of 75, a sensitivity of 74.1%, and a specificity of 63.4%. The area under the ROC curve for predicting prognosis using video electroencephalogram is 0.701, with a sensitivity of 53.7% and specificity of 86.6%. The area under the combined prediction curve is 0.822, with a sensitivity of 77.8% and specificity of 75.6%.Decision curve analysis demonstrated that the combined model provided a higher net benefit across a wide range of clinically relevant threshold probabilities compared to either individual predictor or the all treat/no treat strategies, indicating superior clinical utility. Severe encephalitis is the result of the interaction of multiple factors, and clinical attention should be paid to GCS score, early warning score, DC, and video electroencephalogram. The combined application of DC and bedside video EEG can significantly improve the evaluation efficiency of short-term prognosis in children with severe encephalitis. R725.9