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This study aimed to quantitatively assess all qualified studies and identify the risk factors for HFMD death. A systematic search of the databases PubMed, Medline, Embase and the Cochrane Library was performed. Study heterogeneity and publication bias were estimated. Seven case\u2013control studies involving 1641 participants (634 died and 1007 survived) were included in the meta-analysis. Human enterovirus 71 infection, male, age \u2a7d3 years, vomiting, cyanosis, convulsion, duration of fever \u2a7e3 days, atypical rashes and abdominal distention were not significantly related to HFMD death (<jats:italic>P<\/jats:italic>\u2a7d 0.05). Lethargy (odds ratio (OR) = 6.62; 95% CI 3.61\u201312.14;<jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>= 0%;<jats:italic>P<\/jats:italic>&lt; 0.0001), pneumonoedema\/pneumorrhagia (OR = 4.09; 95% CI 2.44\u20136.87;<jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>= 0%;<jats:italic>P<\/jats:italic>&lt; 0.0001), seizures (OR = 6.85; 95% CI 2.37\u201319.74;<jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>= 0%;<jats:italic>P<\/jats:italic>= 0.0004), dyspnoea (OR = 8.24; 95% CI 2.05\u201333.19;<jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>= 83%;<jats:italic>P<\/jats:italic>= 0.003) and coma (OR = 3.76; 95% CI 1.85\u20137.67;<jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>= 0%;<jats:italic>P<\/jats:italic>= 0.0003) were significantly associated with HFMD death, which were risk factors for HFMD death.<\/jats:p>","DOI":"10.1017\/s0950268819002279","type":"journal-article","created":{"date-parts":[[2020,2,27]],"date-time":"2020-02-27T09:42:07Z","timestamp":1582796527000},"source":"Crossref","is-referenced-by-count":17,"title":["Risk factors for death from hand\u2013foot\u2013mouth disease: a meta-analysis"],"prefix":"10.1017","volume":"148","author":[{"given":"X.F.","family":"Ni","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"X.","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Q.","family":"Xiong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.Y.","family":"Xie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.H.","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y.H.","family":"Peng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5235-7293","authenticated-orcid":false,"given":"X.W.","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2020,2,27]]},"reference":[{"key":"S0950268819002279_ref22","first-page":"904","article-title":"Risk factors of death cases of hand-foot-and-mouth disease in Hunan province","volume":"45","author":"Xu","year":"2011","journal-title":"Zhonghua yu fang yi xue za zhi"},{"key":"S0950268819002279_ref23","doi-asserted-by":"publisher","DOI":"10.1111\/j.1651-2227.2003.tb02478.x"},{"key":"S0950268819002279_ref18","doi-asserted-by":"publisher","DOI":"10.1080\/23744235.2016.1185801"},{"key":"S0950268819002279_ref35","doi-asserted-by":"publisher","DOI":"10.1007\/s12519-018-0189-8"},{"key":"S0950268819002279_ref31","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/169.4.905"},{"key":"S0950268819002279_ref43","doi-asserted-by":"publisher","DOI":"10.1097\/EDE.0b013e318231d67a"},{"key":"S0950268819002279_ref17","doi-asserted-by":"publisher","DOI":"10.1002\/sim.698"},{"key":"S0950268819002279_ref15","doi-asserted-by":"publisher","DOI":"10.1016\/0197-2456(86)90046-2"},{"key":"S0950268819002279_ref16","doi-asserted-by":"publisher","DOI":"10.2307\/2533446"},{"key":"S0950268819002279_ref2","first-page":"875","article-title":"Molecular epidemiology of enteroviruses associated with hand, foot, and mouth disease in the mainland of China","volume":"26","author":"Zhang","year":"2013","journal-title":"Biomedical and Environmental Sciences: BES"},{"key":"S0950268819002279_ref19","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000008934"},{"key":"S0950268819002279_ref12","article-title":"Guidelines on the diagnosis and treatment of hand, foot, and mouth disease","volume":"30","author":"MoHotPsRo","year":"2010","journal-title":"International Journal of Respiration"},{"key":"S0950268819002279_ref9","doi-asserted-by":"publisher","DOI":"10.1186\/1743-422X-9-8"},{"key":"S0950268819002279_ref14","unstructured":"GA Wells BS DOC JP, Welch, V , Losos, M and Tugwell, P . 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