A Validated Nomogram That Predicts Prognosis of Autoimmune Encephalitis: A Multicenter Study in China

Abstract

The aim of this retrospective study was to derive and validate a reliable nomogram for predicting prognosis of autoimmune encephalitis (AE). A multi-center retrospective study was conducted in four hospitals in China, using a random split-sample method to allocate 173 patients into either a training (n = 126) or validation (n = 47) dataset. Demographic, radiographic and therapeutic presentation, combined with clinical features were collected. A modified Rankin Scale (mRS) at discharge was the principal outcome variable. A backward-stepwise approach based on the Akaike information criterion was used to test predictors and construct the final, parsimonious model. Multivariable analysis was conducted using logistic regression to develop a prognosis model and validate a nomogram using an independent dataset. The performance of the model was assessed using receiver operating characteristic curves and a Hosmer-Lemeshow test. The final nomogram model considered age, viral prodrome, consciousness impairment, memory dysfunction and autonomic dysfunction as predictors. Model validations displayed a good level of discrimination in the validation set: area under the Receiver operator characteristic curve = 0.72 (95% Confidence Interval: 0.56–0.88), Hosmer–Lemeshow analysis suggesting good calibration (chi-square: 10.33; p = 0.41). The proposed nomogram demonstrated considerable potential for clinical utility in prediction of prognosis in autoimmune encephalitis.

The prognosis of late‐onset anti‐N‐methyl‐D‐aspartate receptor encephalitis in China

“…Autonomic dysfunction has been demonstrated to be a critical independent indicator of poor short‐term prognosis in elderly adults. The possible causes have been analyzed in our previous article 26 . Thus, early identification and intervention in the elderly population with this clinical manifestation is recommended in aims to improve functional outcomes.…”

Clinical features and brain MRI volumetric changes in anti‐mGluR5 encephalitis

“…All 15 new patients were Asian ethnic background, whereas the previous reported 12 cases were Caucasian ethnic background. Different ethnic backgrounds may be contributory to the discrepancy, as we had reported in our previous studies of a multicenter AE cohort 31 . Besides, one might suspect differences in the detection methods that might lead to under‐diagnosis of tumors in the current study, as only 11 of 15 patients underwent whole‐body 18 F‐FDG PET for tumor screening.…”

Association between red blood cell distribution width-to-albumin ratio and the prognosis in patients with autoimmune encephalitis: a retrospective cohort study

“…Factors in the reported model included viral prodrome (no/yes), memory dysfunction (no/yes), consciousness impairment (no/yes), and autonomic dysfunction (no/yes) ( 4 ).…”

“…AE is considered to be related to antibodies against neuronal cell surface proteins, ion channels, or receptors, and accounts for approximately 20% of all adult encephalitis cases ( 1 , 2 ). As a heterogeneous disease, AE is characterized by complex clinical manifestations and frequent complications ( 3 , 4 ). Although approximately 80% of AE patients recover well after immunotherapy, there are still some patients not responding to the treatments ( 3 , 4 ).…”

“…As a heterogeneous disease, AE is characterized by complex clinical manifestations and frequent complications ( 3 , 4 ). Although approximately 80% of AE patients recover well after immunotherapy, there are still some patients not responding to the treatments ( 3 , 4 ). Therefore, exploring biomarkers related to the prognosis of AE patients is of great clinical significance.…”