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Saturday, 30 November 2013

Encephalitis - The Risk Factors

Encephalitis is defined as a condition of irritation and swelling (inflammation) of the brain, as a result of virus, bacteria and others invasion.
Risk factors
1.  Term infants, while very low birth weight (VLBW) and preterm infants
According to the study by the  Taipei City Hospital, total of 109 episodes of sepsis were identified in 100 neonates. The incidence of sepsis was 4.06% among all NICU admissions. Most neonates with early-onset sepsis were term infants, while very low birth weight (VLBW) and preterm infants accounted for the majority of cases of late-onset sepsis(14).

2. Obesity, operative vaginal delivery and age <25 years
In the study to describe the risk of maternal sepsis associated with obesity and other understudied risk factors such as operative vaginal delivery, found that ontrolling for mode of delivery and demographic and clinical factors, obese women had twice the odds of uncomplicated sepsis (OR 2.12; 95% CI 1.14-3.89) compared with women of normal weight. Age <25 years (OR 5.15; 95% CI 2.43-10.90) and operative vaginal delivery (OR 2.20; 95% CI 1.02-4.87) were also significant predictors of sepsis. Known risk factors for maternal sepsis were also significant in this study (OR for uncomplicated and severe sepsis respectively): multiparity (OR 6.29, 12.04), anaemia (OR 3.43, 18.49), labour induction (OR 3.92 severe only), caesarean section (OR 3.23, 13.35), and preterm birth (OR 2.46 uncomplicated only)(15).

3. Elder
If you are elder, you are at increased risk of sepsis

4. Patient in intensive care and with weakened immune system
Intra-abdominal infections are a common problem for the general surgeon and major sources of morbidity and mortality in the intensive care unit(16). Other indicated that severe sepsis has emerged as a major cause of admission and mortality for hospitalized HIV/AIDS patients, significantly affecting short- and longer-term survival of critically ill HIV/AIDS patients(17).

5. Invasive devices
There is a study of indwelling intravenous polyethylene catheters as factors influencing the risk of microbial colonization and sepsis(18).

6. Obesity and alcpholism
A multivariate analysis revealed that obesity (adjusted odds ratio [aOR] 21.4; 95% confidence interval [CI] 1.8-257.5) and alcoholism (aOR 6.5; 95% CI 1.3-32.8) were important predictive factors for spinal sepsis(18a).
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Sources
(14) http://www.ncbi.nlm.nih.gov/pubmed/19273254
(15) http://www.ncbi.nlm.nih.gov/pubmed/19889755
(16) http://www.ncbi.nlm.nih.gov/pubmed/19633589
(17) http://www.merckvetmanual.com/mvm/index.jsp?cfile=htm/bc/101600.htm
(18) http://www.ncbi.nlm.nih.gov/pubmed/12829337
(19) http://www.ncbi.nlm.nih.gov/pubmed/17680814