Encephalitis continues to be a significant cause of morbidity and mortality with only a few studies assessing prognostic factors.
A multicenter retrospective review of adults with encephalitis as defined by the international encephalitis consortium between 2000-2017 at 19 hospitals in New Orleans, LA and Houston, TX. An adverse clinical outcome was defined as a Glasgow outcome scale between 1-4. Logistic regression analysis was used to evaluate prognostic factors.
A total of 340 adults were enrolled. The mean age was 48 years with 184 (54.1%) being male. Out of 340 patients, 268 (79%) had probable or confirmed encephalitis and 71 (21%) had possible encephalitis. An etiology was documented in 151 cases (44.5%) with the most common etiologies being arboviruses (17%), Herpes simplex virus(HSV)(16.5%), and anti- N-methyl-D-aspartate receptor antibody (13.4%). An adverse clinical outcome was observed in 172 out of 322 (53%) of patients. On bivariate analysis, age > 60 years, respiratory failure, intensive care admission, fever, abnormal neurological exam, abnormal electroencephalogram and abnormal magnetic resonance imaging (MRI) of the brain were associated with an adverse outcome (P<0.05). On logistic regression, only abnormal neurological exam (Odds ratio [OR] 4.310, 95% Confidence Interval [CI] 1.148-12.508), abnormal MRI of the brain (OR 2.131, 95% CI, 1.016-4.469), and fever (OR 2.127, 95% CI, 1.079-4.194) (all P <0.05) remained independently associated with an adverse outcome.
Encephalitis in adults is associated with adverse clinical outcomes in 50% of patients with significant predictors being fever, abnormal neurological exam and abnormal MRI of the brain.
R. Lopez Castelblanco, None
R. Hasbun, None