Table 3.
Predictors of Poor Neurologic Outcome (mRS>2) in Anti-NMDAR Encephalitis Patients with Disturbance of Consciousness at the 12-Month Follow-Up
| Potential Predictors | Total (n=51) | mRS > 2 at 12 Months (n=23) | mRS ≤ 2 at 12 Months (n=28) | P value |
|---|---|---|---|---|
| Gender (n, %) | ||||
| Male | 22 (43.1) | 7 (30.4) | 15 (53.6) | 0.097 |
| Female | 29 (56.9) | 16 (69.6) | 13 (46.4) | |
| Age, mean, (IQR), years | 24 (21, 35) | 24 (22, 46) | 24 (21, 31) | 0.315 |
| Clinical manifestations (n, %) | ||||
| Psychiatric disturbance | 49 (96.1) | 21 (91.3) | 28 (100) | 0.386 |
| Seizures | 42 (82.4) | 20 (87) | 22 (78.6) | 0.680 |
| Involuntary movement | 37 (72.5) | 19 (82.6) | 18 (64.3) | 0.145 |
| Speech dysfunction | 12 (23.5) | 4 (17.4) | 8 (28.6) | 0.349 |
| Autonomic dysfunction | 10 (19.6) | 7 (30.4) | 3 (10.7) | 0.158 |
| Complications (n, %) | ||||
| Pulmonary infection | 30 (58.8) | 17 (73.9) | 13 (46.4) | 0.047 |
| Urinary tract infection | 5 (9.8) | 4 (17.4) | 1 (3.6) | 0.239 |
| Abnormal liver function | 4 (7.8) | 3 (13.0) | 1 (3.6) | 0.466 |
| Deep venous thrombosis | 4 (7.8) | 1 (4.3) | 3 (10.7) | 0.750 |
| Sleep disturbance | 7 (13.7) | 2 (8.7) | 5 (17.9) | 0.591 |
| Tumors | 5 (9.8) | 5 (21.7) | 0 (0.0) | – |
| Mechanical ventilation | 19 (37.3) | 16 (69.6) | 3 (10.7) | <0.001 |
| ICU admission | 19 (37.3) | 14 (60.9) | 5 (17.9) | 0.002 |
| Peripheral blood findings | ||||
| NLR, median, (IQR) | 5.25 (3.23, 7.51) | 5.25 (3.4, 7.18) | 5.11 (2.55, 8.74) | 0.663 |
| CSF findings | ||||
| CSF pleocytosis (n, %) | 29 (56.9) | 12 (52.2) | 17 (60.7) | 0.540 |
| CSF Oligoclonal bands (n, %) | 8 (15.7) | 3 (13.0) | 5 (17.9) | 0.933 |
| Elevated CSF protein (n, %) | 20 (39.2) | 11 (47.8) | 9 (32.1) | 0.254 |
| Elevated IgG index (n, %) | 27 (52.9) | 16 (69.6) | 11 (39.3) | 0.031 |
| Elevated 24-h intrathecal IgG (n, %) | 42 (82.4) | 20 (87.0) | 22 (78.6) | 0.680 |
| QAlb >7.00 (n, %) | 7 (13.7) | 3 (13.0) | 4 (14.3) | 1.000 |
| NMDAR antibody titers (n, %) | ||||
| CSF NMDAR antibody titers positive, (n/%) | 51 (100) | 23 (100) | 28 (100) | – |
| Serum NMDAR antibody titers positive, (n/%) | 38 (74.5) | 18 78.3) | 20 (71.4) | 0.577 |
| Abnormal MRI findings, (n, %) (findings from 46 patients) | 24 (53.3) | 11 (55) | 13 (52.0) | 0.921 |
| Abnormal EEG findings, (n, %) | 44 (86.3) | 21 (91.3) | 23 (82.1) | 0.591 |
| Time from onset to the initiation of immunotherapy (days, median, IQR) | 18 (12, 33) | 34 (18, 49) | 13 (8.25, 18.75) | <0.001 |
Note: Data are n (%) values or median (interquartile range, IQR).
Abbreviations: IQR, interquartile range; ICU, intensive care unit; NLR, neutrophil-to-lymphocyte ratio; CSF, cerebral spinal fluid; 24-h intrathecal IgG, 24-hour intrathecal immunoglobulin G synthesis rate; Qalb, albumin-CSF/serum-quotient; NMDAR, N-methyl-D-aspartate receptor; MRI, magnetic resonance imaging; EEG, electroencephalogram.