From the Department of Neurology, Beijing Tong Ren Hospital, Capital Medical University (Y.P., F.D., L. Liu, Y.L., C.L., L.C., Y.Z., L. Li, Q.M., J.W.); Medical Research Center, Beijing Tong Ren Hospital, Capital Medical University (Y.P., F.D., L. Liu, Y.L., C.L., L.C., Y.Z., L. Li, Q.M., J.W.); Department of Neurology, Beijing Tiantan Hospital, Capital Medical University (W.C., H.Y., X.Z.); Department of Neurology, Xuanwu Hospital, Capital Medical University (A.L.), Beijing; Beijing Children Hospital, Capital Medical University (X.W.); Department of Neurology, the Second Hospital of Hebei Medical University (J.H.), Shijiazhuang; China National Clinical Research Center for Neurological Diseases (W.C., H.Y.), Beijing; Center of Stroke, Beijing Institute for Brain Disorders (W.C., H.Y.); and Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease (W.C., H.Y.), China.
Neurol Neuroimmunol Neuroinflamm. 2020 Aug 5;7(5). doi: 10.1212/NXI.0000000000000860. Print 2020 Sep.
The performance of anti-NMDAR Encephalitis One-Year Functional Status (NEOS) in predicting the 1-year functional status in Chinese patients with anti-NMDAR encephalitis is unknown.
We recruited patients with anti-NMDAR encephalitis from the Multicenter and Prospective Clinical Registry Study of Anti-NMDAR Encephalitis in Beijing Area. Patients were followed up for 1 year. We defined the poor functional status as a modified Rankin Scale score of more than 2 and good functional status as a modified Rankin Scale score of no more than 2. We performed a receiver-operator characteristic analysis to assess the discriminatory power of the NEOS score in predicting the 1-year functional status by using the area under the curve (AUC). Calibration was assessed by Pearson correlation coefficient and Hosmer-Lemeshow tests.
Among the 111 patients with anti-NMDAR encephalitis recruited from 364 potentially eligible participants, 87 (78.4%) had good functional status at 1 year, whereas the remaining 24 (21.6%) had poor functional status. The AUC of the NEOS score for 1-year poor functional status was 0.86 (95% CI 0.78-0.93, < 0.001). The increased NEOS was associated with higher risk of 1-year poor functional status in patients with anti-NMDAR encephalitis.
The NEOS score is considered a reliable predictor of the risk of 1-year poor functional status in Chinese patients with anti-NMDAR encephalitis. This score could help to estimate the velocity of clinical improvement in advance.
NCT02443350.
This study provides Class III evidence that in patients with anti-NMDAR encephalitis, the NEOS score predicts 1-year functional status.
抗 NMDAR 脑炎 1 年功能状态（NEOS）在预测中国抗 NMDAR 脑炎患者 1 年功能状态方面的表现尚不清楚。
我们从北京地区抗 NMDAR 脑炎多中心前瞻性临床登记研究中招募了抗 NMDAR 脑炎患者。对患者进行了 1 年的随访。我们将功能状态不良定义为改良 Rankin 量表评分大于 2 分，功能状态良好定义为改良 Rankin 量表评分不超过 2 分。我们通过曲线下面积（AUC）进行受试者工作特征分析，评估 NEOS 评分在预测 1 年功能状态方面的区分能力。通过 Pearson 相关系数和 Hosmer-Lemeshow 检验评估校准情况。
在纳入的 364 名潜在合格参与者中，111 名抗 NMDAR 脑炎患者中有 87 名（78.4%）在 1 年时功能状态良好，而其余 24 名（21.6%）功能状态不良。NEOS 评分预测 1 年功能状态不良的 AUC 为 0.86（95%CI 0.78-0.93，<0.001）。NEOS 增加与抗 NMDAR 脑炎患者 1 年功能状态不良的风险增加相关。
NEOS 评分被认为是预测中国抗 NMDAR 脑炎患者 1 年功能状态不良风险的可靠指标。该评分有助于提前估计临床改善的速度。
NCT02443350。
本研究提供了 III 级证据，表明在抗 NMDAR 脑炎患者中，NEOS 评分可预测 1 年的功能状态。
