To investigate the risk factors of the severe hand, foot and mouth disease (HFMD) changing into critical several HFMD in children.

The clinical data of the 200 hospitalized children with HFMD in the second Department of Infectious Diseases, Xi’an Children Hospital from July 2014 to July 2015 were reviewed, retrospectively, including 150 children with severe HFMD and 50 cases with critical several HFMD. The clinical manifestations and auxiliary examination results of the two groups were compared by the Logisic regression analysis.

Among the two groups, most children were younger than 5 years, mainly younger than 3 years (75% in several group and 90% in critical several group). The ratio of male and female in the two groups were 2.26∶1 and 9.00∶1, respectively. Most children had fever and rash. Limb trembling, limb weakness, drowsiness, vomiting, convulsion were common when children were involved with in nervous system. According to univariate analysis of Logistic regression, fast heart rate, fast breath, leukocytosis, high blood sugar, fever, limb trembling/weakness, drowsiness, atypical rash, poor peripheral circulation, improved C-reactive protein, pulmonary rales and EV71 positive were all the risk factors of HFMD. Multivariate Logistic regression analysis showed that fast heart rate (χ² = 8.615, P < 0.001), pulmonary rale (χ² = 15.498, P < 0.001), poor peripheral circulation (χ² = 22.153, P < 0.001) were independent risk factors for critical several cases, with significant differences.

According to the close observation of the heart rate, peripheral circulation and pulmonary rales of the patients with severe HFMD, early warning of the occurrence of critical illness could be carried out.