ASSOCIATION BETWEEN CLINICAL OUTCOMES AND EARLY VERSUS LATE HOSPITALIZATION IN CHILDREN WITH MENINGOENCEPHALITIS

Abstract

Background: Meningoencephalitis remains a significant cause of pediatric morbidity and mortality globally, particularly in low- and middle-income countries. Prompt medical intervention is considered critical in reducing adverse outcomes, yet limited data exists from local settings on how hospitalization timing impacts recovery and survival. Given the lack of comparative evidence within Pakistan, evaluating the influence of early versus late hospitalization on clinical outcomes in pediatric meningoencephalitis is both timely and essential.

Objective: To assess and compare clinical outcomes—specifically improvement and in-hospital mortality—between early (within 24 hours) and late (after 24 hours) hospitalization in children diagnosed with meningoencephalitis.

Methods: A prospective cohort study was conducted from January 3 to July 2, 2024, at the Department of Paediatrics, Khyber Teaching Hospital, Peshawar. A total of 260 children aged 2–12 years with a clinical diagnosis of meningoencephalitis were enrolled and divided into two groups: early hospitalization (n = 130) and late hospitalization (n = 130). Participants were followed throughout their hospital stay. Baseline data, including demographics, residence, BMI, parental education, and socioeconomic status, were recorded. Clinical outcomes were measured in terms of symptomatic improvement and in-hospital mortality. Statistical analysis was performed using IBM SPSS version 24.

Results: The mean age was 7.62 ± 2.53 years in the early group and 7.09 ± 2.64 years in the late group. Males comprised 59.2% and 62.3% of the early and late groups, respectively. Improvement was observed in 80 (65.6%) patients with early admission versus 42 (34.4%) in the late group (p = 0.000, OR = 3.35, 95% CI: 2.013–5.582). In-hospital mortality was significantly lower in the early group (15 patients, 30.6%) compared to the late group (34 patients, 69.4%) (p = 0.003, OR = 0.368, 95% CI: 0.189–0.716).

Conclusion: Early hospitalization significantly improves clinical recovery and reduces in-hospital mortality in pediatric meningoencephalitis. Early recognition and timely medical intervention should be prioritized in clinical settings.