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Characterization and prognosis of autoimmune encephalitis in the neurological intensive care unit: a retrospective study

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Abstract

Objective

Patients diagnosed with autoimmune encephalitis (AE) require admission to the neurological intensive care unit (ICU) when they exhibit clinical manifestations such as status epilepticus, central hypoventilation, and severe involuntary movements. In order to determine the predictors of ICU admission and prognosis for patients with AE admitted to the neurological ICU, we analyzed the clinical characteristics of this patient population.

Methods

This retrospective study analyzed 123 patients admitted to the First Affiliated Hospital of Chongqing Medical University between 2012 and 2021 who were diagnosed with AE based on serum and/or cerebrospinal fluid (CSF) AE-related antibody positivity. We divided these patients into two groups: those who received ICU treatment and those who did not. We evaluated patient’s prognosis using the modified Rankin scales (mRS).

Results

Univariate analysis revealed that epileptic seizures, involuntary movements, central hypoventilation, symptoms of vegetative neurological disorders, increased neutrophil-to-lymphocyte ratio (NLR), abnormal electroencephalogram (EEG) findings, and different treatments were associated with ICU admission for patients with AE. Multivariate logistic regression analysis showed that hypoventilation and NLR were independent risk factors for ICU admission in AE patients. Univariate analysis showed that age and sex were related to prognosis in ICU-treated AE patients, and logistic regression analysis indicated that age was the only independent risk factor for prognosis in ICU-treated AE patients.

Conclusion

Increased NLR, except for hypoventilation, is an indicator of ICU admission in AE patients. Although a large number of patients with AE require ICU admission, the overall prognosis is good, particularly in younger patients.

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Funding

This study was supported by the Joint Medical Research Project of Chongqing Science & Technology and Health Commission (2020FYYX081), High-Level Medical Reserved Personnel Training Project of Chongqing, and Natural Science Foundation of Yuzhong Direct, Chongqing (20190129).

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Author notes

  1. Ningxiang Qin and Jing Wang contributed equally to this work.

Authors and Affiliations

  1. Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China

    Ningxiang Qin, Jing Wang, Xingguo Wu, Wei Wang, Xuefeng Wang & Liang Wang

  2. Department of Neurology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China

    Xi Peng

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  1. Ningxiang Qin
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  2. Jing Wang
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  3. Xingguo Wu
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  4. Wei Wang
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  5. Xuefeng Wang
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  6. Xi Peng
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  7. Liang Wang
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Corresponding authors

Correspondence to Xi Peng or Liang Wang.

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This study was approved by the Ethics Committee of the First Affiliated Hospital of Chongqing Medical University.

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Qin, N., Wang, J., Wu, X. et al. Characterization and prognosis of autoimmune encephalitis in the neurological intensive care unit: a retrospective study. Neurol Sci 44, 2889–2895 (2023). https://doi.org/10.1007/s10072-023-06778-w

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  • DOI: https://doi.org/10.1007/s10072-023-06778-w

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