Factors associated with Febrile seizure in febrile children with upper respiratory tract infection

Abstract

Background: The inflammatory response throughout the body has been linked to the development of febrile seizures (FS). Although fever is a common symptom in children, only some develop FS.

Objective: To determine factors affecting the occurrence of febrile seizures in patients with upper respiratory tract infection accompanied by fever.

Methods: This case control study included patients admitted to the hospital with upper respiratory tract infections aged between 6 months and 5 years. The data was collected retrospectively for a total of five years. The sample comprised 202 individuals, divided into 101 patients with febrile seizures and 101 without. Statistical analysis included the Chi-square, T-test and  logistic regression to determine factors for febrile seizure occurrence, and the determination of appropriate cutoff points using the Youden index.

Results: Among 202 children, factors associated with febrile seizures were identified. The mean body temperature in the febrile seizure group was 39.18±0.76 degrees Celsius. For every 1 degree Celsius increase in temperature, the risk of febrile seizures increased  (OR=5.44; 95% CI 3.19-9.28; p-value <0.01). Analyzing the factors associated with febrile seizures using multiple logistic regression, and adjust for gender, age, weight, height, family history of febrile seizures, family history of epilepsy, vaccination history, history of influenza, peak body temperature, Hb (g/dL), Hct (%), MCV (fL), and RDW (%), it was found that An increase in the Neutrophil to Lymphocyte Ratio (NLR) (adj.OR=18.15; 95%CI=6.60-49.91; p-value=<0.01). The highest body temperature (in degrees Celsius) (adj.OR=2.19; 95%CI=1.23-3.91; p-value=<0.01). Additionally, variables associated with FS included lymphocyte counts less than 3536 cells/µL (sensitivity 85.14%, specificity 33.66%, AUC=0.39), neutrophil counts greater than 4480 cells/µL (sensitivity 87.18%, specificity 77.22%, AUC=0.88), and a neutrophil to lymphocyte ratio greater than 0.9 (sensitivity 91.08%, specificity 71.28%, AUC=0.85).

Conclusions. factors associated with the occurrence of febrile seizures, the Neutrophil to Lymphocyte Ratio (NLR) and peak body temperature. Additionally, the Neutrophil to Lymphocyte Ratio is a better predictor of febrile seizures than lymphocyte counts and neutrophil counts.