抗 NMDAR 脑炎中国患者 NEOS 评分的验证。
Validation of the NEOS score in Chinese patients with anti-NMDAR encephalitis.
机构信息
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.
出版信息
Neurol Neuroimmunol Neuroinflamm. 2020 Aug 5;7(5). doi: 10.1212/NXI.0000000000000860. Print 2020 Sep.
OBJECTIVE
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.
METHODS
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.
RESULTS
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.
CONCLUSIONS
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.
CLINICALTRIALGOV IDENTIFIER
NCT02443350.
CLASSIFICATION OF EVIDENCE
This study provides Class III evidence that in patients with anti-NMDAR encephalitis, the NEOS score predicts 1-year functional status.
目的
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。
方法
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。
结果
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。
结论
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。
临床试验注册号
NCT02443350。
证据分类
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。
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