Risk Factors for Intensive Care Unit Admission in Patients with Autoimmune Encephalitis
BackgroundPrevention and early recognition of critical illness in patients with autoimmune encephalitis (AE) is essential to achieve better outcome.Aim of the studyTo evaluate risk factors for intensive care unit (ICU) admission and its prognostic impact in patients with AE.Patients and methodsA rec...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2017-07-01
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| Series: | Frontiers in Immunology |
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| Online Access: | http://journal.frontiersin.org/article/10.3389/fimmu.2017.00835/full |
| _version_ | 1819056250686537728 |
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| author | Gayane Harutyunyan Larissa Hauer Martin W. Dünser Tobias Moser Slaven Pikija Markus Leitinger Helmut F. Novak Wolfgang Aichhorn Eugen Trinka Johann Sellner Johann Sellner |
| author_facet | Gayane Harutyunyan Larissa Hauer Martin W. Dünser Tobias Moser Slaven Pikija Markus Leitinger Helmut F. Novak Wolfgang Aichhorn Eugen Trinka Johann Sellner Johann Sellner |
| author_sort | Gayane Harutyunyan |
| collection | DOAJ |
| description | BackgroundPrevention and early recognition of critical illness in patients with autoimmune encephalitis (AE) is essential to achieve better outcome.Aim of the studyTo evaluate risk factors for intensive care unit (ICU) admission and its prognostic impact in patients with AE.Patients and methodsA reclassification of patients hospitalized between 2011 and 2016 revealed 17 “definite” and 15 “probable” AE cases. Thirteen patients (41%) developed critical illness and required ICU admission. The underlying conditions were intractable seizures or status epilepticus (54%), altered mental state (39%), and respiratory failure (8%).ResultsICU admission was associated with longer time from first symptoms to hospitalization (p = 0.046). Regression analysis revealed that anemia on hospital admission and definite diagnosis of AE was associated with a higher risk of acquiring critical illness. At last follow-up after a median of 31 months (range 2.5–52.4), seven patients had died (23%) and 63% had a good outcome [modified Rankin Scale (mRS) 0–3]. Anemia was associated with poor prognosis (p = 0.021), whereas development of critical illness did not impact mortality and functional outcome.ConclusionWe confirmed the need for ICU care in a subgroup of patients and the prevailing objective is improved seizure control, and definite diagnosis of AE and anemia were identified as risk factors for development of critical illness. However, prognosis was not affected by ICU admission. |
| first_indexed | 2024-12-21T13:20:26Z |
| format | Article |
| id | doaj.art-81135daf572540c282c9067cf68242bd |
| institution | Directory Open Access Journal |
| issn | 1664-3224 |
| language | English |
| last_indexed | 2024-12-21T13:20:26Z |
| publishDate | 2017-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Immunology |
| spelling | doaj.art-81135daf572540c282c9067cf68242bd2022-12-21T19:02:35ZengFrontiers Media S.A.Frontiers in Immunology1664-32242017-07-01810.3389/fimmu.2017.00835278958Risk Factors for Intensive Care Unit Admission in Patients with Autoimmune EncephalitisGayane Harutyunyan0Larissa Hauer1Martin W. Dünser2Tobias Moser3Slaven Pikija4Markus Leitinger5Helmut F. Novak6Wolfgang Aichhorn7Eugen Trinka8Johann Sellner9Johann Sellner10Department of Neurology, Christian Doppler Medical Center, Paracelsus Medical University, Salzburg, AustriaDepartment of Psychiatry and Psychotherapy, Christian Doppler Medical Center, Paracelsus Medical University, Salzburg, AustriaDepartment of Critical Care, University College of London Hospital, London, United KingdomDepartment of Neurology, Christian Doppler Medical Center, Paracelsus Medical University, Salzburg, AustriaDepartment of Neurology, Christian Doppler Medical Center, Paracelsus Medical University, Salzburg, AustriaDepartment of Neurology, Christian Doppler Medical Center, Paracelsus Medical University, Salzburg, AustriaDepartment of Neurology, Christian Doppler Medical Center, Paracelsus Medical University, Salzburg, AustriaDepartment of Psychiatry and Psychotherapy, Christian Doppler Medical Center, Paracelsus Medical University, Salzburg, AustriaDepartment of Neurology, Christian Doppler Medical Center, Paracelsus Medical University, Salzburg, AustriaDepartment of Neurology, Christian Doppler Medical Center, Paracelsus Medical University, Salzburg, AustriaDepartment of Neurology, Klinikum rechts der Isar, Technische Universität München, München, GermanyBackgroundPrevention and early recognition of critical illness in patients with autoimmune encephalitis (AE) is essential to achieve better outcome.Aim of the studyTo evaluate risk factors for intensive care unit (ICU) admission and its prognostic impact in patients with AE.Patients and methodsA reclassification of patients hospitalized between 2011 and 2016 revealed 17 “definite” and 15 “probable” AE cases. Thirteen patients (41%) developed critical illness and required ICU admission. The underlying conditions were intractable seizures or status epilepticus (54%), altered mental state (39%), and respiratory failure (8%).ResultsICU admission was associated with longer time from first symptoms to hospitalization (p = 0.046). Regression analysis revealed that anemia on hospital admission and definite diagnosis of AE was associated with a higher risk of acquiring critical illness. At last follow-up after a median of 31 months (range 2.5–52.4), seven patients had died (23%) and 63% had a good outcome [modified Rankin Scale (mRS) 0–3]. Anemia was associated with poor prognosis (p = 0.021), whereas development of critical illness did not impact mortality and functional outcome.ConclusionWe confirmed the need for ICU care in a subgroup of patients and the prevailing objective is improved seizure control, and definite diagnosis of AE and anemia were identified as risk factors for development of critical illness. However, prognosis was not affected by ICU admission.http://journal.frontiersin.org/article/10.3389/fimmu.2017.00835/fullautoimmune encephalitishumoral immunitycritical careneurodegenerationseizuresprognosis |
| spellingShingle | Gayane Harutyunyan Larissa Hauer Martin W. Dünser Tobias Moser Slaven Pikija Markus Leitinger Helmut F. Novak Wolfgang Aichhorn Eugen Trinka Johann Sellner Johann Sellner Risk Factors for Intensive Care Unit Admission in Patients with Autoimmune Encephalitis Frontiers in Immunology autoimmune encephalitis humoral immunity critical care neurodegeneration seizures prognosis |
| title | Risk Factors for Intensive Care Unit Admission in Patients with Autoimmune Encephalitis |
| title_full | Risk Factors for Intensive Care Unit Admission in Patients with Autoimmune Encephalitis |
| title_fullStr | Risk Factors for Intensive Care Unit Admission in Patients with Autoimmune Encephalitis |
| title_full_unstemmed | Risk Factors for Intensive Care Unit Admission in Patients with Autoimmune Encephalitis |
| title_short | Risk Factors for Intensive Care Unit Admission in Patients with Autoimmune Encephalitis |
| title_sort | risk factors for intensive care unit admission in patients with autoimmune encephalitis |
| topic | autoimmune encephalitis humoral immunity critical care neurodegeneration seizures prognosis |
| url | http://journal.frontiersin.org/article/10.3389/fimmu.2017.00835/full |
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