Patient selection: age < 14 years with falciparum malaria
Neurologic involvement includes:
(1) seizures
(2) agitation
(3) prostration
(4) reduced level of consciousness, including coma
Risk factors for neurological involvement (adjusted odds ratios ranging from 1.6 to 3.7):
(1) history of seizures in the past
(2) fever lasting <= 2 days at time of admission
(3) delayed capillary refill (increased by > 2 seconds)
(4) metabolic acidosis (base deficity > 8 mmol/L)
(5) hypoglycemia
Factors reducing the risk of neurological involvement:
(1) one or more comorbid conditions (in addition to the malaria)
(2) severe anemia
Risk factors for mortality (adjusted odds ratios ranging from 2.5 to 5):
(1) reduced level of consciousness
(2) respiratory distress (sustained nasal flaring, deep acidotic breathing, subcostal retractions)
(3) severe anemia
(4) hypoglycemia
(5) hyperkalemia (> 5 mmol/L)
(6) bacteremia
(7) seizures after hospital admission
