Meta-analysis Of The Risk Factors For Severe Hand Foot And Mouth Disease

Objective To investigate the main risk factors of severe Hand foot and mouth disease(HFMD)so as to provide evidences for early recognition in clinical.Methods Such databases as Pub Med, Cochrane library, VIP Database for Chinese Technical Periodicals, Wan fang Periodicals and Dissertation Database, and CNKI were electronically searched to collect case-control studies on risk factors for severe Hand foot and mouth disease(HFMD). Two reviewers independently screened studies according to the inclusion and exclusion criteria, extracted data, and assessed methodological quality. Then, meta-analysis was performed using Rev Man 5.3 soft ware.Results 26 studies involving 10784 participants which including 3 114 cases and 3 527 controls were included for this meta-analysis. The results showed that, fever no less than 3 days, the thermal spike greater than or equal to 39℃, younger than 3 years old, infection of EV71,hyper startling, vomiting, fatigue, neurological signs, hyperglycemia, elevated white blood cell(WBC) count were associated with the severe Hand foot and mouth disease(HFMD), with pooled OR(95%CI) values of 2.64(1.84～3.79),2.36(2.05～2.72),2.37(1.59～3.52),5.1(2.84～9.14),13.88(6.02～32.03),4.08(1.68～9.92),5.71(3.65～8.94),2.42(1.67～3.50),2.14(1.82～2.51),1.63(1.29～2.07).Conclusion Fever no less than 3 days, the thermal spike greater than or equal to 39℃, younger than 3 years old, Infection of EV71, hyper startling, vomiting, fatigue, neurological signs, hyperglycemia, elevated WBC count are reliable risk factors of severe Hand foot and mouth disease(HFMD).