Clinical Features and Outcomes in Adult Patients with Autoimmune Encephalitis Requiring Intensive Care: A Retrospective Cohort Study.

IF 3.6 3区医学 Q2 CLINICAL NEUROLOGY

Neurocritical Care Pub Date : 2025-09-16 DOI:10.1007/s12028-025-02374-2

Lixia Qin, Kexin Chen, Yiwen Zhou, Wei Wang, Wei Lu, Hainan Zhang

{"title":"Clinical Features and Outcomes in Adult Patients with Autoimmune Encephalitis Requiring Intensive Care: A Retrospective Cohort Study.","authors":"Lixia Qin, Kexin Chen, Yiwen Zhou, Wei Wang, Wei Lu, Hainan Zhang","doi":"10.1007/s12028-025-02374-2","DOIUrl":null,"url":null,"abstract":"Background: This study aims to explore the predictors of poor outcomes by analyzing the clinical characteristics and prognosis of adult patients with severe forms of autoimmune encephalitis (AE) requiring intensive care unit (ICU) admission.Methods: A retrospective analysis was conducted on 134 adult patients diagnosed with definite or possible AE and admitted to the neurology ICU between January 2015 and December 2023. Neurological outcomes at 6 and 12 months were assessed using the modified Rankin scale (mRS). The study further analyzed the relationship between their clinical characteristics, auxiliary examinations, and prognosis.Results: A total of 134 adult patients with AE requiring ICU admission were included. The 6- and 12-month survival rates were 91.8% and 91.5%, respectively. At 6 months, 72.4% (97 of 134) of patients had favorable outcomes (mRS score ≤ 2), whereas 27.6% (37 of 134) had poor outcomes (mRS score ≥ 3). Compared with the favorable group, patients in the poor outcome group were older (42.92 vs. 30.71 years, p = 0.002), had a higher incidence of tumors (24.3% vs. 4.1%, p < 0.001), and were more likely to require mechanical ventilation (67.6% vs. 26.8%, p < 0.001). They also had lower Glasgow Coma Scale scores on ICU admission (p = 0.006), higher Acute Physiology and Chronic Health Evaluation II scores (p = 0.006), elevated cerebrospinal fluid glucose (p = 0.004) and protein levels (p = 0.029), higher autoantibody seronegativity (32.4% vs. 13.4%, p = 0.011), lower glucocorticoid use (p = 0.038), and longer ICU stays (p = 0.031). Multivariate logistic regression identified age (p = 0.001), presence of tumor (p = 0.03), mechanical ventilation (p = 0.025), antibody negativity (p = 0.042), and ICU length of stay (p = 0.000) as independent predictors of poor prognosis.Conclusions: These factors may help identify high-risk patients with AE early, enabling timely and targeted interventions to improve outcomes.","PeriodicalId":19118,"journal":{"name":"Neurocritical Care","volume":" ","pages":""},"PeriodicalIF":3.6000,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Neurocritical Care","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s12028-025-02374-2","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background: This study aims to explore the predictors of poor outcomes by analyzing the clinical characteristics and prognosis of adult patients with severe forms of autoimmune encephalitis (AE) requiring intensive care unit (ICU) admission.

Methods: A retrospective analysis was conducted on 134 adult patients diagnosed with definite or possible AE and admitted to the neurology ICU between January 2015 and December 2023. Neurological outcomes at 6 and 12 months were assessed using the modified Rankin scale (mRS). The study further analyzed the relationship between their clinical characteristics, auxiliary examinations, and prognosis.

Results: A total of 134 adult patients with AE requiring ICU admission were included. The 6- and 12-month survival rates were 91.8% and 91.5%, respectively. At 6 months, 72.4% (97 of 134) of patients had favorable outcomes (mRS score ≤ 2), whereas 27.6% (37 of 134) had poor outcomes (mRS score ≥ 3). Compared with the favorable group, patients in the poor outcome group were older (42.92 vs. 30.71 years, p = 0.002), had a higher incidence of tumors (24.3% vs. 4.1%, p < 0.001), and were more likely to require mechanical ventilation (67.6% vs. 26.8%, p < 0.001). They also had lower Glasgow Coma Scale scores on ICU admission (p = 0.006), higher Acute Physiology and Chronic Health Evaluation II scores (p = 0.006), elevated cerebrospinal fluid glucose (p = 0.004) and protein levels (p = 0.029), higher autoantibody seronegativity (32.4% vs. 13.4%, p = 0.011), lower glucocorticoid use (p = 0.038), and longer ICU stays (p = 0.031). Multivariate logistic regression identified age (p = 0.001), presence of tumor (p = 0.03), mechanical ventilation (p = 0.025), antibody negativity (p = 0.042), and ICU length of stay (p = 0.000) as independent predictors of poor prognosis.

Conclusions: These factors may help identify high-risk patients with AE early, enabling timely and targeted interventions to improve outcomes.

查看原文本刊更多论文

需要重症监护的自身免疫性脑炎成年患者的临床特征和结局：一项回顾性队列研究

背景：本研究旨在通过分析重症自身免疫性脑炎（AE）成人患者的临床特征和预后，探讨不良预后的预测因素。方法：回顾性分析2015年1月至2023年12月神经内科ICU收治的134例确诊或可能发生AE的成人患者。使用改良Rankin量表（mRS）评估6个月和12个月的神经预后。进一步分析其临床特点、辅助检查与预后的关系。结果：共纳入134例需要ICU住院的AE成人患者。6个月和12个月生存率分别为91.8%和91.5%。6个月时，72.4%（134例中97例）的患者预后良好（mRS评分≤2），而27.6%（134例中37例）的患者预后不良（mRS评分≥3）。与预后良好组相比，预后不良组患者年龄更大（42.92岁vs. 30.71岁，p = 0.002），肿瘤发生率更高（24.3% vs. 4.1%, p）。结论：这些因素可能有助于早期识别AE高危患者，及时、有针对性地干预，改善预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Neurocritical Care 医学-临床神经学

CiteScore

7.40

自引率

8.60%

发文量

221

审稿时长

4-8 weeks

期刊介绍： Neurocritical Care is a peer reviewed scientific publication whose major goal is to disseminate new knowledge on all aspects of acute neurological care. It is directed towards neurosurgeons, neuro-intensivists, neurologists, anesthesiologists, emergency physicians, and critical care nurses treating patients with urgent neurologic disorders. These are conditions that may potentially evolve rapidly and could need immediate medical or surgical intervention. Neurocritical Care provides a comprehensive overview of current developments in intensive care neurology, neurosurgery and neuroanesthesia and includes information about new therapeutic avenues and technological innovations. Neurocritical Care is the official journal of the Neurocritical Care Society.