Development of a short-term prognostic model for anti-N-methyl-D-aspartate receptor encephalitis in Chinese patients

作者：Jingxiao Zhang, Yatong Li, Lei Liu, Feifei Dai, Yujing Peng, Qiuying Ma, Lin Li, Hong Yu, Aihua Liu, Xinghu Zhang, Xiaohui Wang, Junying He, Hui Bu, Yanjun Guo, Hanqiu Jiang, Shilei Cui, Houliang Sun, Jiawei Wang · 发表于：BMC Neurology · 年份：2024 · DOI：10.1186/s12883-024-03724-x · 被引用次数：8 · 研究领域：Autoimmune Neurological Disorders and Treatments、Epilepsy research and treatment、Immunodeficiency and Autoimmune Disorders

BACKGROUND: Recognizing the predictors of poor short-term prognosis after first-line immunotherapy in patients with anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is essential for individualized treatment strategy. The objective of this study was to ascertain the factors that forecast short-term prognosis in patients with anti-NMDAR encephalitis, develop a prognostic prediction model, and authenticate its efficacy in an external validation cohort. Further, all patients were followed-up long-term to assess the factors of long-term outcome and relapses. METHODS: A prospective enrollment of patients diagnosed with anti-NMDAR encephalitis was conducted across five clinical centers in China from June 2014 to Mar 2022. The enrolled patients were divided into the derivation and validation sets based on enrollment time. The short-term prognostic model was visualized using a nomogram. Further, all patients were followed-up long-term to assess the factors of long-term outcome. RESULTS: This study found that poor short-term prognosis was a risk factor for poor long-term outcome (6-month prognosis, OR 29.792, 95%CI 6.507-136.398, p < 0.001; 12-month prognosis, OR 15.756, 95%CI 3.384-73.075, p < 0.001; 24-month prognosis, OR 5.500, 95%CI 1.045-28.955, p = 0.044). Abnormal behavior or cognitive dysfunction (OR 8.57, 95%CI 1.48-49.79, p = 0.017), consciousness impairment (OR19.32, 95%CI 3.03-123.09, p = 0.002), autonomic dysfunction or central hypoventilation (OR 5.66, 95%CI 1...